11 days old

Coding Auditor Educator (Nonexempt)

Mercy Health
Lewiston, ME 04240
  • Job Code
    R022787

Thank you for considering a career at Ensemble Health Partners!

Job Description

Summary:

The audit professional integrates medical coding principles and objectivity in the performance of coding auditactivities. Draws on ICD10CM, HCPCS, NCCI, and CMS coding expertise and industry knowledge to substantiate coding principles to determine potential billing/coding issues, and quality concerns. Under indirect supervision, the Coding Auditor will audit the quality of all acute care outpatient work types to assure appropriateness and accuracy of Diagnoses, CPT, HCPCS, CCI edits, modifier assignment in accordance with ICD10 CM, ICD10PCS, CPT, HCPCS, CPT Assistant, Coding Clinic, Center of Medicare and Medicaid (CMS) guidelines, and National Correct Coding Initiatives (NCCI).

Essential Functions:

  • The audit professional integrates medical coding principles and objectivity in the performance of coding audit activities.
  • Draws on ICD10CM, HCPCS, NCCI, and CMS coding expertise and industry knowledge to substantiate coding principles to determine potential billing/coding issues, and quality concerns.
  • Participates in client system education to gain the knowledge necessary to audit client accounts in ensuring that the coding is supported by the patient's clinical documentation, coding/cdi guidelines and other regulatory standards/guidelines as appropriate.

  • Maintain meticulous documentation, spreadsheets, account, and claim examples of root cause issues. Performs searches of governmental, payor-specific, hospital-specific, regulatory body, and literature rules, regulations, guidelines to identify and coding and billing requirements to make recommendations to clients.

  • Assist in the development and coordination of the executive summary reports, education and training client coding companion as it relates to the outcomes of the coding audit.

  • Meet established productivity standards for coding audits & coding certification requirements.

  • Attends coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations.

  • Provides excellent customer service, in an organized and efficient manner, while maintaining a positive attitude.

  • Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.

  • Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures.

Travel:

  • This position will support our client in Lewiston, Maine. It is required that the candidate will be able to travel locally to the Lewiston area to provide education to providers.
  • Expectations are 25% travel or to the office as needed.

Requirements:

  • Accepted: RHIA or RHIT and CCS or COC or CPCand CRCR

  • Preference: CPMA but others accepted CCS or COC, Certified Revenue Cycle Representative (CRCR) if not a CRCR must obtain within 90 days of employment.

  • At least three (3) years of experience directly related to the duties and responsibilities specified.

  • Knowledge of auditing concepts and principles

  • Advanced knowledge of medical coding and billing systems, documentation, and regulatory requirements

  • Ability to use independent judgement and to manage and impart confidential information

  • Ability to analyze

  • Strong written communication and interpersonal skills

  • Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation

  • Knowledge of current and developing issues and trends in medical coding procedures requirements

  • Ability to clearly communicate medical information to professional practitioners and/or the general public

  • Ability to adapt and modify medical billing procedures, protocol, and data management systems to meet specific operating requirements

  • Ability to provide guidance and training to professional and technical staff in area of expertise.

  • Ability to flex work schedule on an as needed basis to meet the business needs

  • Competent with the use of all Microsoft Office applications, including Word, Excel, and Power Point

  • Epic experience

Ensemble Health Partners is an equal opportunity employer.

Well also reward your hard work with:

  • Great health, dental and vision plans
  • Prescription drug coverage
  • Flexible spending accounts
  • Life insurance w/AD&D
  • Paid time off
  • Tuition reimbursement
  • And a lot more
Scheduled Weekly Hours:40

Work Shift:

Days (United States of America)

Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact our Human Resources Department at 877-692-7780 or EnsembleHRTeam@ensemblehp.com. This department will make sure you get connected to a Human Resources representative that can assist you.

Compensation & Benefits
EEO is the Law
FMLA Rights - English

La FMLA Espaol







Posted: 2019-10-31 Expires: 2019-11-29
Sponsored by:
Farm Credit Services of America Logo
Sponsored by:
Bank of America Logo

Featured Jobs[ View All ]

Featured Employers

Before you go...

Our free job seeker tools include alerts for new jobs, saving your favorites, optimized job matching, and more! Just enter your email below.

Share this job:

Coding Auditor Educator (Nonexempt)

Mercy Health
Lewiston, ME 04240

Join us to start saving your Favorite Jobs!

Sign In Create Account
Powered ByCareerCast