Under the direction of the Manager of Coding Audit and Education, the Coding Auditor is responsible for performing coding quality audits on a wide variety of inpatient and outpatient services. The position requires this coder to be highly proficient in the proper assignment of ICD-10-CM, PCS, CPT, HCPCS and modifier codes. Demonstrated ability to provide direction to coding staff as it relates to coding integrity, effective and compliant query application and adherence to Tenet procedures.
ï¿½Provides written, detailed rationale and supporting evidence for recommendations on audit findings.
ï¿½Delivers educational feedback to coding staff regarding audit findings.
ï¿½Provides guidance to coding staff and management in identifying and resolving coding issues.
ï¿½Collaborates with the clinical documentation improvement team for conflicts between code assignments.
ï¿½Identifies documentation improvement opportunities that impact coding accuracy.
ï¿½Initiates physician queries for clarification of documentation in the medical record to achieve accurate code assignment and coding integrity.
ï¿½Reviews and researches billing edits.
ï¿½Assists with DRG denials from payers including researching and writing appeal letters.
ï¿½Ability to interpret Medicare and NCCI guidelines, National and Local Coverage Determinations to support coding compliance.
ï¿½Performs other duties as assigned including training/mentoring of new staff and performing research related to special projects
Other Job Functions:
ï¿½Reports results of audits to departments and committees as assigned
ï¿½Identifies opportunities for intradepartmental and interdepartmental operational improvements.
ï¿½Participates in coding program related meetings, physician and staff education, staff development, departmental activities and in-service opportunities.
ï¿½Five years progressive coding or coding review experience in an acute care setting, including auditing
ï¿½Comprehensive understanding of coding guidelines, Coding Clinics, CPT Assistant, CCI edits, and appropriate coding references along with the ability to employ these coding resources to audit findings.
ï¿½Excellent interpersonal verbal and written communication skills to accurately relay information to internal and external customers.
ï¿½Excellent organizational skills with ability to trend and track audit findings effectively.
ï¿½Excellent problem-solving skills, the ability to work independently, and to perform under pressure in a teamwork manner with diplomacy and tact.
ï¿½Proficient computer and technical skills, along with experience using MS Word, Excel and PowerPoint.
ï¿½American Health Information Management Association (AHIMA) certification required such as RHIA, RHIT or CCS
ï¿½An associateï¿½s degree or higher in a health-related discipline
Primary Location: Dallas, Texas
Facility: Tenet Headquarters
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 2005020691
About Tenet Headquarters
Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.