Coding Validator Telecommute

Summary

Reports to PFS Manager responsible for audit and education. Performs coder and provider audits of ICD-10 codes CPT codes and

HCPCS codes. Prepares training materials and provides education as needed. Stays abreast of industry and payer changes

pertaining to coding and documentation guidelines.

C. A. R. E. Values

Brown University Health employees are expected to successfully role model the organization�s values of Compassion

Accountability Respect and Excellence as these values guide our everyday actions with patients customers and one another.

In addition to our values all employees are expected to demonstrate the core Success Factors which tell us how we work together

and how we get things done. The core Success Factors include:

� Instill Trust and Value Differences

� Patient and Community Focus and Collaborate

Responsibilities

Audit professional ambulatory medical records for multispecialty provider organization to assure billed codes are accurately

supported by the documentation.

Possess knowledge of teaching physician regulations including incidenttosplit shared and attestation requirements.

Review diagnoses procedures and modifiers assigned by coders and record outcomes. Share completed audit results with

Validation Team Leadership who will relay results to Coding Manager and/or Director so they can provide feedback to the individual

coders as needed.

Review diagnoses and procedures assigned by providers and record outcomes. Shared completed audit results with Validation

Team Leadership who will relay results to individual providers and provider leadership.

Stay abreast of coding and documentation guidelines compliance policies annual coding updates payer policies and industry

changes. Utilize this knowledge inday to dayworkload.

Identify coding/documentation trends that may pose a risk to Brown University Health or its revenue stream and report such trends

to management team. Recommend improvements to documentation templates in Epic that will minimize compliance risk and

facilitate accurate documentation for the providers. Assure documentation is defensible in the event of an external audit.

Work with Practices/Clinics Providers Coding Team Corporate Compliance Risk Management Contracting and Payers to help

assure that all departments are consistently on the same page and able to provide accurate feedback to coders and providers.

Abides by the Standards of Ethical Coding as set forth by the American Academy of Professional Coders and American Health

Information Management Association.

Performs other duties as assigned.

Other Information

EDUCATION:

Successful completion of coding certification program (CPC).

Understanding of the content of the medical record. Trained in medical terminology medical science anatomy and physiology.

Ability to recognize and understand clinical documentation pertinent for coding. Good writing skills to communicate

coding/documentation issues clearly. Computer literate; capable of researching websites to access regulatory requirements. Ability

to navigate the patient electronic medical record.

Excellent written and oral communication skills. Proficient in Microsoft Word Excel and other computer applications.

EXPERIENCE:

Five years coding experience preferably in a large academic multispecialty organization. Past auditing experience or strong

background in coding preferred.

WORKING CONDITION AND PHYSICAL REQUIREMENTS:

Normal office environment.

INDEPENDENT ACTION:

Performs independently within the department's policies and procedures. Refers specific complex problems to the supervisor when

clarification of the departmental policies and procedures are required.

SUPERVISORY RESPONSIBILITY:

None