FMOL Health · 8 hours ago
Coding Audit Coordinator
Baton Rouge, LA
Full-time
Onsite
Senior Level
5+ years expFMOL Health is seeking a Coding Audit Coordinator to review documentation and coding of hospital records to ensure compliance with federal and state laws. The role involves performing audits of coding quality, maintaining statistical spreadsheets, and collaborating with various departments to enhance coding education and compliance.
Health Care
Responsibilities
Medical Coding Review
Assist in the development, performance and maintenance of a long term comprehensive, clinical coding audit program for inpatient and outpatient coding. Conducts coding compliance and charge-based coding audits, inpatient and outpatient coding reviews
Performs quarterly complex coding quality audits on each coder. Reviews 100% of coding performed by new staff until preset quality standards are met. Audits clinics with autocoding feature for accuracy of documentation and correct diagnosis assignment
Designs and implements additional coding and billing audits on items of focus and vulnerability based on RACs, OIG workplan, public profile sites and other areas considered high-risk from a compliance standpoint
Prepares reports based on audit results (including recommendations for improvement); analyzes coding data to identify coding variations and determine cause for variation. Presents findings to Corporate Coding leadership. Provides input to coding manager on quality of coding for each coder at yearly evaluation
Assists FMOLHS in reviews related to internal or external investigations
Quality/Compliance Review
Performs code-based charge audits to assure compliant claims data and monitors adherence to government and third-party billing requirements to optimize revenue generation. Researches and appeals payment denials received from payers as necessary within designated timelines. Analyzes any identified patterns in NCCI edits and assists FMOLHS facilities with implementing process improvement initiatives to prevent claim failures
Works with compliance officer to ensure that FMOLHS entities comply with coding/billing laws and guidelines
Identifies opportunities for documentation improvement and/or process changes
Collaboration & Partnership
Collaborates with coding manager and coding educator to identify educational opportunities from results of quarterly audits. Assists coding educator in development of education specific to issues/opportunities identified during auditing/monitoring of coding
Identifies any medical staff training needed from issues/opportunities found during audits, notifying coding manager and coding educator of educational needs. Assists in providing training to coders, hospital staff and physicians for ICD-10-CM/PCS future implementation
Assists in compiling information as needed for various Medical Staff, Medical Records and Quality meetings
Serves as a resource to Internal Audit staff/RMD on coding and chargemaster-related issues
Other Duties As Assigned
Performs other duties as assigned or requested
Stays abreast of the latest developments, advancements, and trends in the field of coding by attending educational programs, reading professional journals, actively participating in professional organizations, and maintaining certification. Integrates knowledge gained into current work practices
Qualification
Required
5 years IP and OP coding experience
Bachelors degree with RHIA and CCS; Associates degree with RHIT and CCS (if not current CCS, position contingent on CCS within 3 months of hire)
Extensive knowledge of coding to include proficiency in coding of inpatient, outpatient, ambulatory surgery and ER visits using knowledge of ICD-9 and CPT coding; assignment of DRGs, APCs and official coding guidelines
CCS
Company
FMOL Health
FMOL Health is a bold, connected health system that delivers care that prioritizes people – every patient, every community, every time – while honoring the unique character of each market we serve.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Richard R. Vath
Interim President and CEO
Eric Clay
Vice President and Chief Security Officer
Recent News
Franciscan Missionaries of Our Lady Health System
2025-11-03
2025-10-11
Company data provided by crunchbase