Medical Coder Auditor Specialist

1 week ago


Chapel Hill, North Carolina, United States UNC Health Care Full time
Overview

UNC Health Care is an inclusive organization with a diverse team of over 40,000 employees. Our mission is to improve the health and well-being of unique communities we serve. We are committed to providing high-quality healthcare services, and our team plays a crucial role in achieving this goal.

Job Summary

We are seeking a skilled Coding and Compliance Professional to join our HIM Coding & CDI Quality team. In this role, you will train and audit medical coders, provide mentoring and training, and ensure compliance with federal, state, and third-party regulations. You will also analyze coded records, educate physicians and staff on error trends, and communicate with various stakeholders to obtain missing information or clarify existing information.

Key Responsibilities

- Audit inpatient and outpatient medical coders to ensure a minimum of 95% accuracy and recommend education and training related to results.
- Assign and/or audit IP and OP Coders' assignment of ICD-10 diagnostic and procedural codes, CPT codes with modifiers, and other applicable codes in an accurate and productive manner on inpatient, outpatient (observation, ambulatory surgery, and ancillary cases).
- Fax, track, and monitor coding denials and appeals on both inpatient and outpatient cases. Review coding insurance denials and refer clinical coding denials to the CDI Physician Advisors.
- Resolve insurance denials that have been accepted by updating the coding and send for rebilling if required.
- Generate coding appeals for insurance denials with sound arguments and based on coding guidelines and conventions.
- Research and resolve problems referred by coders and provide prompt feedback.
- Provide input on performance of coders and audit information to supervisor for performance evaluations.
- Provide information to physicians and other healthcare staff regarding current coding practices and changes in 3rd party, state, and federal regulations and guidelines.
- Provide training and serve as a general resource to assist other coders and members of department staff.
- Participate in and provide education sessions as needed on specific coding topics at huddle meetings and other forums.

About the Role

This is a full-time position working remotely with a standard work schedule of 40 hours per week. The salary range is $27.89 - $40.09 per hour, determined by experience and internal equity. If selected, you may remain a UNCHCS State employee.

As an equal opportunity employer, UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply.

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