What are the responsibilities and job description for the Nurse Practitioner, Coding Auditor position at Personalized Health Partners - Cincinnati, OH?
Personalized Health Partners is currently recruiting Nurse Practitioner Coding Auditors. These positions can be mostly remote.
The PHP Nurse Practitioner Coding Auditor has a passion for inspecting medical documentation for clinical and coding accuracy. The nurse practitioner coding auditor will review documentation of PHP providers for accuracy and provide feedback to clinical leadership and education to providers based on audit findings.
Job Summary :
The primary role of the Nurse Practitioner Coding Auditor is to review and assesses the accuracy, completeness, specificity and appropriateness of diagnosis codes identified in the medical record completed by Personalized Health Partner clinical providers. In addition, this role will be responsible for understanding the relationship between ICD-10-CM coding and HCC (hierarchical condition categories) and communicating audit findings with the providers so that optimal accuracy can be assured. The responsibilities of the auditor in this role will be, but not limited to :
- Reviews medical records within required timelines to determine completion and compliance with CMS and coding best practices
- Reviews and assesses the accuracy, completeness, specificity, and appropriateness of diagnosis codes identified in the medical record
- Communicates timely and effectively with the coding leadership and the clinical team regarding issues or corrections with the medical record
- Understands the relationship between ICD-10-CM coding and HCC (hierarchical condition categories) coding
- Demonstrates a commitment to integrating coding compliance standards into coding practices
- Identifies, corrects, and reports coding problems
- Maintains adequate knowledge of coding, compliance, and reimbursement procedures related to Medicare risk adjustment
- Makes recommendations for coding policy / changes
- Follows all legal and policy requirements for HIPAA protected data
- Actively demonstrates teamwork at all times
- Strong familiarity with the Coding Clinic
- Expert level understanding of coding guidelines and is able to use and apply appropriate judgement
EDUCATION and QUALIFICATION :
Required :
Preferred Qualifications :
JOB SKILLS
LI-Remote
