Coding Auditor

Health Care Excellence for Maui since 1961 - The leading provider of  quality health care for the residents and visitors of Maui as measured by :
-  patient satisfaction
-  patient outcomes
-  staff employment satisfaction

MAUI MEDICAL GROUP, INC.                                                 POSITION DESCRIPTION

Position Title

Department

Coding Auditor

Provider Services Department

INSTRUCTIONS:

In Section A briefly describe the overall purpose of this position.  Describe the position so that someone who does not know the position will understand it.  In Section B describe the specific tasks or duties.  The percentage of time spent performing the major job responsibilities is used for job evaluation purposes only.  In Section C list the minimum qualifications, type of equipment used (including the frequency), characteristics, and environmental factors relating to this position.

SECTION A: OVERALL PURPOSE OF THE POSITION

Codes office and hospital procedures for providers. Provides education for providers to improve coding and documentation.  Reviews and analyzes diagnoses and procedures codes used by providers in accordance with establish coding guidelines.  

SECTION B: MAJOR JOB RESPONSIBILITIES

*

PERCENTAGE

1. In accordance with establish coding guidelines; codes office and hospital procedures for providers and reviews and analyzes diagnoses and procedures codes used by for assigned providers prior to submission of charges. 

     Understands and uses appropriate diagnosis, HCPCS and CPT codes on all             procedures and services performed.

     Ensures strict confidentiality of all information. 

60

1. Assists with audits of records in accordance with establish coding guidelines. Ensures that the final diagnosis accurately reflects the care and treatment rendered as documented in the notes. Reviews the records for compliance with established reimbursement and special screening criteria. Reports compliance problems appropriately.

15

1. Provides education for providers to improve coding and documentation.

10

1. Attends seminars and in-services as required to remain current on coding issues.

5.0

1. All other miscellaneous responsibilities and duties as assigned.

5.0

1. Demonstrates quality work, completes assignments on a timely basis, and makes decisions within limits of authority.   Takes initiative in problem solving, maintains confidentiality of patient and company information, and interacts with patients, co-workers, and management in a courteous and respectful manner.  Adheres to all company policies and procedures.

2.5

1. Maintains attendance standards consistent with company policy.

2.5

   Total 100%

Enter an asterisk (*) in this column to indicate Major Job Responsibilities that are essential functions.

SECTION C: OTHER INFORMATION

RESPONSIBLE TO:

Provider Services Manager

MINIMUM QUALIFICATIONS:

Education/Experience -

High School Diploma.  Medical Coding Certificate - RHIT or CPC certification is required. Excellent interpersonal skills. Two years' experience using ICD10-CM, CPT, HCPCs or equivalency.  Computer competency.  Must be able to manage multiple tasks at the same time. Maintains a positive "can-do" attitude.  Must be able to work overtime or after hours as the need arises.

Skills/Knowledge -

Knowledge of auditing concepts and principles. Advanced knowledge of medical coding and billing systems and regulatory requirements. Ability to use independent judgment and to manage and impart confidential information. Ability to analyze and solve problems. Strong communication and interpersonal skills. Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation. Knowledge of current and developing issues and trends in medical coding procedures requirements. Ability to clearly communicate medical information to professional practitioners and/or the public. Detailed knowledge of medical coding systems, procedures, and documentation requirements. Ability to adapt and modify medical billing procedures, protocol, and data management systems to meet specific operating requirements. Ability to provide guidance and training to professional and technical staff in area of expertise.

Desired/Preferred Qualifications:

Possesses coding/auditing experience with a current certification. Demonstrates effective written and verbal communication.    

Equipment Use:

Personal computer, telephone, and 10 key machine. Microsoft products, Internet and e-mail.

Characteristics

Must be willing to effectively participate as a team member with Medical/Business office staff. Must be committed to the protection of confidential information, records, and/or reports. Must have the ability to communicate effectively in a professional and courteous manner. Must have good organizational skills.

Environmental Factors:

Requires prolonged sitting. Required some bending, stooping, and stretching for files and supplies. Requires manual dexterity sufficient to operate a keyboard and other office equipment. Vision must be correctable to 20/20 and hearing must be in the normal range for telephone contacts.

Hourly Rate:

Starting @ $23.98; based on experience

Maui Medical Group is an equal employment opportunity/affirmative action employer. We actively seek diversity among our employees. We do not discriminate on the basis of age, race, color, religion, sex/gender (including gender identity/expression), ancestry/national origin, disability, marital status, arrest and court record, sexual orientation, pregnancy, veteran status, genetic information, domestic or sexual violence victim status, or other protected categories in accordance with state and federal laws. We further encourage individuals with disabilities, minorities, and veterans to apply.