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Coding Compliance Auditor
2 months ago
Position Overview
As a Coding Compliance Auditor, you will play a vital role in ensuring adherence to coding standards and reimbursement protocols within our healthcare system. Your expertise will contribute to the overall quality of patient care and operational efficiency.
Key Responsibilities
- Conduct thorough evaluations of hospital inpatient coding compliance to verify alignment with payer reimbursement methodologies and established coding standards. Provide comprehensive summaries of quality review outcomes to the coding management team.
- Address and resolve coding inquiries from various departments within the organization, leveraging your knowledge of coding practices.
- Act as a subject matter expert in diagnosis and procedure coding, medical terminology, and relevant reimbursement guidelines, ensuring accurate interpretation of coded data as it pertains to revenue cycle compliance.
- Collaborate with the Coding Educator to identify audit trends and contribute to the development of ongoing educational materials for coding staff and physicians.
- Assist in identifying and implementing process enhancements based on industry best practices to optimize resource utilization, reduce costs, and elevate coding services across specialized service lines.
Qualifications
- High School Diploma/GED with a minimum of 5 years of relevant coding experience within the organization in lieu of a degree - Required
- Associate's Degree - Required
- Bachelor's Degree - Preferred
- 5 years of coding experience pertinent to auditing specialty with RHIT/RHIA certification - Required, or
- 5 years of coding experience within the organization relevant to the auditing specialty with CCS certification - Required
- 2 years of experience in a Coding Support role with RHIT/RHIA certification - Preferred
Travel Requirements: Minimal travel expected.
Equal Opportunity Commitment
Franciscan Alliance is dedicated to providing equal employment opportunities to all employees and qualified applicants, in accordance with applicable laws. We uphold a commitment to equal opportunity in all employment practices.
