Professional Coding Auditor
2 weeks ago
We are seeking a skilled Coding Compliance Specialist to join our team at Franciscan Health. As a key member of our coding team, you will play a critical role in ensuring the accuracy and compliance of our coding practices.
Key Responsibilities- Evaluate prebill hospital inpatient coding compliance edits to ensure adherence to payer reimbursement methodologies and official coding guidelines.
- Summarize quality review results for Coding Managers, Supervisors, Coding Educator, and coding staff, and participate in team meetings to discuss coding findings.
- Respond to coding inquiries from other Franciscan departments and serve as a subject matter expert on diagnosis and procedure codes, coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, and payer-specific guidelines.
- Provide detailed information on audit trends to the Coding Educator for ongoing education and notify coding leadership of trends and topics for education and feedback to coders, physicians, and departments.
- Assist with identifying and implementing process improvements according to industry best practice standards to optimize resources, reduce costs, and enhance coding services across specialized service lines.
- High School Diploma/GED with 5 years of Franciscan coding experience in lieu of degree - Required
- Associate's Degree - Required
- Bachelor's Degree - Preferred
- 5 years Coding Experience relevant to auditing specialty with RHIT/RHIA - Required, or 5 years Franciscan coding experience relevant to the auditing specialty with CCS - Required
- 2 years Coding Support role with RHIT/RHIA - Preferred
Travel is not a requirement for this role.
Equal Opportunity EmployerFranciscan Health is an equal opportunity employer and is committed to providing equal employment opportunities to all employees and qualified applicants for employment as otherwise required by an applicable local, state, or Federal law.
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