Clinical Coding Auditor

Sentara Healthcare

Introduction:

Job Description:

Job Summary :

Performs a number of functions including those of physician education, internal auditing, coder education, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara’s patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in either APCs or DRGs, and is expected to achieve mastery of at least one payment methodology within one year. Follows audit plan, completing numerous audits and providing follow-up to coders, management, and physicians. Looks for new problem areas, trends, etc., and advises Director of Clinical Coding of same.

Required Education:

High School Grad or Equivalent

Experience:

Required: Coding – 4 years

Licenses and Certifications:

Required: Cert Coding Specialist, Cert Professional Coder

Preferred: Reg Health Information Admin, Reg Health Information Tech

Skills:

Required: Communication, Complex Problem Solving, Critical Thinking

Additional Requirements:

Minimum 4 years experience coding complex inpatient cases or outpatient cases in an acute care setting. Associates degree preferred. Certified Coding Specialist (CCS) is required for inpatient auditor. Certified Professional Coder (CPC, COC) or CCS is required for outpatient auditors

Compensation/Benefits:

Competitive and commensurate with experience.

Instructions for Resume Submission:

Please email resume to Lisa Senkowski at lasenkow@sentara.com