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Coding Auditor, Physician Billing

Company: rush university medical center
Location: Chicago
Posted on: November 23, 2021

Job Description:

Job Title:Coding Auditor, Physician Billing Department:PB Revenue Integrity Shift:1st Specialty:Coding Job Number:2021-3494 Date Posted:10/19/2021 Position Type: Job Qualifications: Coding Auditor, Physician Billing Physician Billing Revenue Integrity Position Highlights: As a key role in the Revenue Integrity team, the Coding Auditor is responsible for conducting reviews of EMR documentation of patient encounters to ensure coding accuracy and documentation adequacy. The Coding Auditor professional will work collaboratively with coders/providers to improve revenue cycle integrity while seeking and identifying trends and opportunities for coding optimization. The incumbent will regularly conduct coding reviews of CPT, ICD-10, and modifier utilization. Position Responsibilities: Coordinates, schedules and performs reviews of professional services and documentation performed by RUMG & ROPPG providers and abstracted by Revenue Integrity coders for quality. Provide feedback and focused educational programs on the results of auditing, review claim denials pertaining to coding, and implement corrective action plans. Evaluates clinical documentation to identify inconsistency or improvement opportunities that could impact reimbursement, revenue integrity, and/or reduce denials. Reviews charge information submitted by certified coders, claim forms, and insurance correspondence to determine if coding, billing, claim follow-up, payment receipts, posting activities, and credit processing is being performed in an accurate and timely manner and is supported by documentation. Prepares written reports of the audit findings to internal leadership, clinical leadership, and providers. Develops educational presentations, learning tools, and training material. Provides education to coders for appropriate CPT, ICD-10, and modifiers based on supporting documentation and EMR charge capture support. Seeks to establish collaborative relationships with coding staff, clinical providers, Corporate Compliance, Revenue Cycle leaders, in the support of coding education and documentation adequacy. Assists in the development of corrective action plans and participates in compliance investigations as needed. Manages special projects individually or in collaboration with other departments. Track coding quality and documentation improvements to measure ROI, organizational growth and support of CPI initiatives. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures. Performs job functions adhering to service principles with customer service focus on I-Care values. Position Qualifications Include: Certified Professional Coder (CPC) or Certified Coding Specialist- Physician Based (CCS-P) required; Certified Professional Medical Auditor (CPMA) and/or Surgical Coding certifications preferred. Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) certification in conjunction with physician based coding experience, including evaluation & management (E/M) and surgical coding experience, may be considered contingent upon CPC, CCS-P or CPMA certification being acquired within the first 6 months of employment. Bachelor's Degree Preferred A minimum of three (3) years of auditing, E/M and/or surgical coding experience required. Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing, with demonstrated ability to interpret such guidelines. Demonstrates an advanced knowledge and skill in analyzing patient records to identify non-conformances in CPT, ICD-10-CM and HCPCS code assignment by passing a department administered coding proficiency test. Demonstrates commitment to continuous learning and performs as a role model to other coding staff. Experience working in a Teaching Hospital setting preferred. Prior experience with billing and claims processing preferred. Prior experience working in a hospital or clinical setting is preferred. Strong communication and organizational skills. Proficient in Excel, Word, Data Entry, computerized health care billing software knowledge, experience in Epic Ambulatory a plus Company Highlights: Rush University is ranked 22nd on the Times Higher Education's 2016 list of the world's top 150 universities under 50 years of age. Rush University is a health science university that is integral to Rush, an academic health system that includes three hospitals and numerous outpatient care facilities. Rush University's Nursing Administration program is ranked in the top four in the nation by U.S. News & World Report. Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics. by Jobble

Keywords: rush university medical center, Chicago , Coding Auditor, Physician Billing, Healthcare , Chicago, Illinois

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