Summary: Under the general supervision of the Coding Manager, the Coding Validator will perform ongoing audits of inpatient and outpatient medical records to validate the accuracy of ICD-10-CM/PCS, CPT, HCPC’s, POA indicators and modifiers. Responsible for developing reports and identifying positive/negative coding trends. Will communicate with the medical staff regarding retrospective coding queries and provide recommendations for education to coders, physicians, CDI and quality. Will review external audit findings, write appeals and provide feedback and education to coders as appropriate.

Education: AS or BS in Health Information Technology/Administration.

Licensure: CCS required.

Experience: Extensive ICD-9-CM, ICD-10-CM/PCS and CPT 4 coding experience in an acute care setting required. Validation experience required.

Skills and Abilities:

· Team leader, with excellent verbal, written and interpersonal skills.

· In depth and up-to-date knowledge and understanding of anatomy and physiology, medical terminology, patho-physiology and pharmacy in order to read, analyze and code the medical record.

· In-depth knowledge of ICD-9-CM, ICD-10 CM and PCS and CPT-4 coding principles and conventions.

· In-depth knowledge of reimbursement methodologies.

· Ability to communicate and work effectively with physicians and other professional staff.

· Current knowledge of coding reference materials; e.g. 3M references, AHA Coding Clinic, AMA CPT Assistant, etc.

· Accurate data entry and retrieval skills in multiple computer systems