Quality Auditor Outpatient | Health Info & Record Mgmt | Day Shift

University of Florida - Leesburg, FL

Full-time

Leesburg, FL

Educational Services

About the position

The Quality Auditor for Outpatient services is a critical role responsible for the ongoing quality review and assessment of coded hospital data. This position involves performing audits on the accuracy of various coding systems including ICD-10-CM/PCS, CPT-4, MS-DRG, APR-DRG, and APC assignments as appropriate. The auditor will prepare detailed reports for management review, identifying trends and areas for improvement. Regularly scheduled audits of individual coders will be conducted, alongside focused retrospective audits to ensure compliance and accuracy in coding practices. In addition to conducting audits, the Quality Auditor will manage all audits conducted by both internal and external entities, responding to requests for code verification as needed. This role requires collaboration with the Coding Manager and/or Coding Assistant Manager to contribute to the development of educational and training opportunities for staff, ensuring that all team members are up-to-date with the latest coding standards and practices. The Quality Auditor plays a vital role in maintaining the integrity of coded data, which is essential for accurate reimbursement and compliance with healthcare regulations.

Responsibilities

• Perform ongoing quality review and assessment of coded hospital data.
• Conduct audits on the accuracy of ICD-10-CM/PCS, CPT-4, MS-DRG, APR-DRG, and APC assignments.
• Prepare reports for management review and identify trends in coding accuracy.
• Conduct focused retrospective audits and regular scheduled audits of individual coders.
• Manage all audits conducted by internal and external entities and respond to requests for code verification.
• Collaborate with the Coding Manager and/or Coding Assistant Manager to develop educational and training opportunities for staff.

Requirements

• Post High School Special Training in a relevant field.
• Registered Health Information Administrator (RHIA) OR Certified Coding Specialist (CCS) OR Registered Health Information Technician (RHIT) OR Certified Professional Coder (CPC) OR Certified Professional Coder-Hospital (CPC-H) certification required.
• Minimum of 3 years experience in hospital inpatient and/or outpatient medical record coding and reimbursement.
• Strong knowledge of ICD-10 CM/PCS and/or CPT coding based on area of assignment.
• Proficiency with Microsoft Windows Operating Systems and Office applications such as Word, Excel, PowerPoint, and coding/grouping software.
• Ability to read, write, speak, and understand English fluently.
• Ability to communicate clearly both written and verbally.
• Ability to generate reports for management review that present audit results clearly.
• Ability to meet deadlines and adapt to frequent changes in regulation.
• Ability to maintain positive and productive relationships with internal and external teams and customers.
• Ability to work independently and be a self-starter.

Nice-to-haves

• Coding audit experience preferred.