Remote California Workers' Compensation Auditor

Summary

The California Workers's Compensation Coding Auditor reviews client records to assure accurate coding based on California regulations and official guidelines. They perform coding audits, provide education to coders, maintain confidentiality, and promote company values. The position requires a minimum of 5 years of experience in California workers' compensation coding work, with at least 3 years of production coding and 2 years of auditing experience.

Requirements

• High school diploma or GED certificate
• Completion of a formal coding program with one of these coding credentials: Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or other AHIMA or AAPC approved coding credential
• Minimum of five (5) years of California workers' compensation coding work experience
• Two years of California workers' compensation coding review experience and coder education experience with working knowledge of the ICD-10-CM and CPT-4 coding systems
• PC proficiency in word processing, spreadsheets, and database software
• Daily communication with clients and supervisors, exhibiting adaptability, excellent customer service, and professional written and verbal communications skills
• A personal computer meeting the requirements of the position

Responsibilities

• Performs coding quality and accuracy audits
• Identifies and verifies the principal and secondary diagnoses based on Official Guidelines for Coding and Reporting
• Identifies procedures based on Official Coding Guidelines and validates ICD-10-PCS codes
• Validates the MS-DRG or other DRG for inpatient cases based on official guidelines
• Reviews facility health records for accuracy and completeness of coding and DRG assignment, where applicable
• Provides education to coders on proper utilization of facility guidelines, Official Coding Guidelines, and Coding Clinic advice
• Performs coding audits in an efficient and productive manner utilizing good time management and professional work habits. Meets productivity standards for the position
• Refers coding questions to a manager or designee in a timely manner for feedback and coding guideline development. Seeks assistance only after exhausting all resources
• Continually enhances coding skills. Participates in coding roundtables, meetings, and educational conferences to ensure coding practice is up-to-date
• Maintains confidentiality and safeguards the privacy of protected health information
• Promote the company’s values
• Perform other job-related duties as may be assigned or required