Coding Quality Auditor, PBO-Coding

Job Description

Performs ongoing coding audits, provides feedback to coding staff, compiles and reports results.


Coding Audits - 40% Performs routine coding audits evaluating accuracy of assignment of codes, disposition, POA indicators and DRGs as indicated. Performs focus coding audits on specific topics, DRGs codes etc. Provides feedback to coders on an individual basis and communicates educational opportunities to CCS Educator. Tracks results of audits and reports findings as indicated. Considers feedback from the coders as appropriate.

Education - 20% Works with the coding managers and Coding Educator to identify topics for educational and training purposes. Assists Coding Educator in development of training materials and identification of case examples. Attends educational sessions to ensure continuity among auditors and coders. Responds to coder questions and reviews cases as necessary to assist with correct code assignment.

Coding assistance -5% Assists with coding when necessary to help meet department goals.

Case Review -15% Review cases in question by outside agencies, payers, UCH Quality and other internal departments. Communicates findings/rationale for code and DRG assignment. Coordinates corrections with coding staff Tracks and reports on denial activities and final results.

Provides coding expertise -10% Serves as the primary resource for coding questions, information and feedback for CCS associates as well as other UC Health departments and personnel.

Accountability -10% Reviews educational materials thoroughly and takes responsibility for applying this information to their duties Seeks to clarify information and educational material when necessary. Listens actively. Maintains information and resources in an organized manner so that information can be referenced easily. Reviews emails timely and thoroughly and responds when indicated. Manages the remote work setting effectively and comes on site when system, connectivity or other issues arise that would impact work performance.


Minimum Education Required: Bachelor's Degree in Science or related field. Preferred: Master's Degree. Certification through American Society for Clinical Pathology required.

Minimum Experience Required: 1-2 years equivalent experience. Preferred: 3-5 years equivalent experience.