Position Title: IRF Auditor (Part-time/PRN)
This person will provide IP and OP IRF audits biannually for 4 facilities (200 records every 6 months). This position is 100% remote
This position will provide retrospective review of documentation as appropriate to the IRF-PAI as well as for the UB-04. Will determine CMG and any financial impact (underpayment and overpayment)to reimbursement.
- Analyze health record to identify etiologic diagnosis and all co-morbidities and complications.
- Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines.
- Ensures all required documentation to meet IRF medical necessity is complete and timely.
- Ensures that all Queries to the medical staff and other clinical caregivers are compliant and necessary.
- Identifies potential quality, severity of illness, risk of mortality, hospital/physician profiling, and reimbursement issues or missing documentation.
- Communicates documentation issues clearly and succinctly to clinical care providers and reports issues/ trends to appropriate manager.
- Provides ongoing education to physicians and other clinical care providers related to documentation, changes in coding, compliance issues, profiling concerns, and reimbursement changes during exit conference
- Monitor changes in law, regulations, rules, and code assignment that impact documentation and reimbursement.
- Completes data worksheets and executive summary for each assignment
- RHIA, RHIT, and/or CCS
- CDIP not required but a plus
- Preferred experience in an IRF
- Preferred two years minimum experience in IRF auditing
Director of Facility Coding