CODING AUDITOR I

Qualifications

Education
Associate's Degree Completion of an accredited coding program 2 Years Relevant work experience in lieu of degree Required

Experience
1 Year minimum experience in medical record reviews, documentation and coding; preferably in an ambulatory physician setting. (with Associate's degree) Required

OR
3 Years minimum experience in medical record review, documentation and coding; preferably in an ambulatory physician setting (without Associate's degree) Required

AND
Experience interpreting all types of medical records, including physician documentation Required
Comprehensive knowledge of ICD-9 and ICD-10 Required
HCC experience preferred

Licenses and Certifications
CPC - Certified Professional Coder Certified Professional Coder Upon Hire Required

OR
Other CPC-A Upon Hire Required

Skills
Strong time management skills required
Personal discipline to work remotely without direct supervision
Ability to remain productive under time constraints and meet deadlines critical to the business
Ability to navigate within various EMRs (Electronic Medical Records)
Working knowledge of medical terminology, anatomy, and physiology
Intermediate skills in Microsoft Outlook, Word, and Excel
Strong interpersonal, communication (verbal, non-verbal and listening) skills
Exemplary attention to detail and completeness
Strong organization, interpersonal, and customer service skills 

Position Responsibilities of a SWHR Coder I

HCC Chart Audits and Projects:
Ability to code using an ICD-10-CM code book
Abstract clinical data from health records and assign appropriate ICD-10-CM codes, mapping to applicable HCC models
Perform outpatient clinical documentation improvement queries based on provider documentation as needed
Knowledge of HIPAA, recognizing a commitment to privacy, security, and confidentiality of all medical records
Meet production goals set by team supervisor for HCC chart audits, form review, etc. while maintaining 95% accuracy
Assist in monitoring problems related to claims data in capturing HCC codes
Maintain tools, methods and standards for HCC coding and documentation
Daily crosschecking to meet quality standards
Meet projects with month end deadlines
Perform other job duties as assigned

Education:
Provide education based on chart review results and any annual changes from CMS in regards to Risk Adjustment
Responsible for all education requests for assigned clinics

Why Southwestern Health Resources 
As a Southwestern Health Resources you’ll enjoy: comprehensive benefits, including a 401(k) with match; paid time off; competitive health insurance choices; healthcare and dependent care spending account options; wellness programs to keep you and your family healthy; tuition reimbursement; a student loan repayment program; and more.

Moving healthcare forward
At the heart of SWHR are people who help people. We care about those we serve and each other.  To be the national leader in providing population-based healthcare, our more than 850 employees use their knowledge, data insights and clinical experience to deliver care to the right patient, at the right time and in the right setting. By connecting physicians to patients and clinical insights to better outcomes, SWHR lowers costs, optimizes value, and builds a better healthcare system for all.

We invite you to learn more about us at www.southwesternhealth.org.

Let’s move healthcare forward – together.

Highlights:

• Combining the strengths of UT Southwestern Medical Center, Texas Health Resources and more than 2,500 community physicians, we offer the largest provider network in North Texas. SWHR covers approximately 700,000 patient members across 16 counties in North Texas.
• SWHR is the parent organization of Care N’ Care Insurance Co., a leading regional Medicare Advantage health plan organization that serves approximately 17,000 patients in North Texas.

Additional perks of being a Coder I:

• Gain a sense of accomplishment by contributing in a teamwork environment
• Positively impact patients’ quality of life
• Receive excellent mentorship, comprehensive training and dedicated clinical leadership resources
• Enjoy opportunities for growth

Explore Southwestern Health Resources Careers for more information and to search all career opportunities.