Job Summary: The Outpatient Coding Auditor monitors coding and provides quality reviews for all outpatient, day surgery and observation accounts. This position assists the Coding Manager in training and education for Coder I and Coder II.

Essential Job Functions & Accountabilities:

1. Assists the Coding Manager in training and education of coding staff.
2. Performs quality reviews of coders ensuring accuracy with coding guidelines and policies for complete, precise, and consistent coding.
3. Reviews include Outpatient ICD-10, CPT, HCPCS and Modifiers.
4. Maintains up-to-date working knowledge of coding guidelines. Acts as a resource and point person for issues and questions for coders, customers or project teams.
5. Reviews physician documentation for coding appropriateness and accuracy following coding guidelines.
6. Provides feedback to coders and providers on coding corrections, appropriately citing authoritative resources.
7. Assists with the interpretation of codes and other information requested for accurate code assignment.
8. Communicates with management regarding clinical, coding, and reimbursement issues as needed.
9. Utilizes Epic, 3-M encoder, and computer-assisted coding (CAC) software as directed.
10. Maintains compliance with JPS Health Network’s coding policies, procedures.
11. Job description is not an all-inclusive list of duties and may be subject to change with or without notice. Staff are expected to perform other duties as assigned.