Professional Billing Coding Auditor

1 week ago


Columbus, United States Columbus Regional Hospital Full time

What you need to know about this position:

+ Responsible for evaluating and auditing provider coding and documentation compliance to determine appropriate code assignments for diagnoses and services performed (HCPCS/CPT codes).

+ Develops quality audit reports that identify trends and educational opportunities.

+ Responsible for training and educating providers, clinical staff, and departments, one-on-one and in a group setting, on all aspects of coding and documentation utilizing both oral and written direction.

+ Prepares training and presentations on applicable topics.

+ Serves as a resource for information or clarification on accurate and ethical coding and documentation standards, guidelines, and regulatory requirements and new coding initiatives.

+ Proactively identifies areas of opportunity to improve coding quality based on audit feedback, coder questions, physician escalations, denial meetings, and other platforms and plans provider education accordingly.

+ Assists in the formulation and review of policies and guidelines affecting the coding of professional services.

+ Requires strong organizational skills and the ability to meet deadlines independently.

+ Requires the ability to professionally interact with physicians and mid-level providers with strong skill in verbal and written communications and customer relations.

+ Accurately applies ICD-9-CM, ICD10 CM and CPT-4 classification systems, utilizing Optum.

+ Assists Manager with monitoring, coordinating and responding to external audits and questions.

+ The hourly range for this position is between $26.65 and $40.00. Individual compensation is determined for this position through years of directly relevant experience. The hourly compensation is only a portion of the total rewards package and a comprehensive benefits program is available for qualifying positions.

+ In this position you will be required to work full-time, 8:00AM-5:00PM, Monday through Friday.

+ This position is partial remote eligible.

What is required for this position:

Education and/or Experience

+ A minimum of 5 years of coding and audit experience required.

+ 7 years of coding and/or audit experience with additional experience performing training and providing feedback to coding and physician audiences preferred.

+ Previous experience in management, quality improvement, compliance, auditing and revenue cycle related activities preferred.

+ Bachelor's degree in Health Information Management or other healthcare related degree preferred.

+ A score of 90% or higher on the Coding Assessment Tool is required.

Certifications, Licenses, Registrations

+ One of the following is required:

+ Certified Coding Specialist (CCS)

+ Certified Coding Specialist - Physician Based (CCS-P)

+ Certified Outpatient Coder (COC)

+ Certified Professional Coder (CPC)

+ Certified Inpatient Coder (CIC)

+ Registered Health Information Administrator (RHIA)

+ Registered Health Information Technician (RHIT)

+ Certified Professional Medical Auditor (CPMA) or Certified Documentation Improvement Practitioner (CDIP) certification preferred.



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