Lead Coding Auditor Specialist

4 weeks ago


Peosta, Iowa, United States Trinity Health Full time

Employment Type:

Full-time Shift:

PRIMARY RESPONSIBILITIES:


Deliver education and support concerning coding and billing principles and regulations, aligned with the Corporate Compliance Plan, to physicians, management, clinical personnel, coding teams, and insurance representatives.

Collaborate with the Director of Patient Accounts to pinpoint opportunities for process enhancements within the procedure coding domain. Regularly engage with the Director of Patient Accounts to assess and refine processes from billing to reimbursement.
Communicate updates regarding billing process modifications to managers and clinical teams. Ensure that relevant staff have access to and understand billing and compliance regulations. Guarantee adherence to Medicare and other payer regulations, along with the Corporate Compliance Plan. Facilitate and coordinate billing compliance training. Conduct compliance evaluation activities under the guidance of the Corporate Compliance Officer. Address compliance issues and contribute to corrective action plans with the Corporate Compliance Officer.

Offer CPT/ICD and billing expertise to the practice across all billing aspects; implement changes in billing practices in response to regulatory updates and reimbursement requirements.

Serve as the team leader for all procedure billing personnel, providing education, information, and evaluation of billing practices. Assist management in staff development, problem resolution, and assessment of operational efficiencies and practices.
Execute assigned procedure coding, including CPT and ICD application, and input into PM software for billing.
Regularly reconcile scheduled case lists with billed procedures.
Act as a liaison between billing and insurance teams. Provide billing education to insurance personnel to ensure accurate and timely billing and reimbursement processes.

ADDITIONAL RESPONSIBILITIES:
Perform related tasks as necessary.

MINIMUM QUALIFICATIONS:
Proficient in computer keyboard usage. A minimum of 7 years of coding and billing experience is required. ACS-CA, CPC-Cardio, and/or CPC-CTS certification is mandatory or must be obtained within one year of employment. High School diploma or GED equivalent.
Our Commitment to Diversity and Inclusion: Trinity Health is among the largest not-for-profit, Catholic healthcare systems in the nation.

Rooted in our Mission and Core Values, we incorporate diversity, equity, and inclusion in all our endeavors.

Our workforce is composed of individuals with varied experiences, customs, abilities, and talents. Together, we achieve our fullest potential. A diverse and inclusive workforce ensures the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer.

All qualified candidates will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.



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