Coder Quality Auditor

O.N.E Purpose

Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.

Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.

Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.

The Opportunity

CAREER OPPORTUNITY OFFERING: Bonus Incentives
Paid Certifications
Tuition Reimbursement
Comprehensive Benefits
Career Advancement

This position pays between $57,400 to $99,000 annually based on experience.

Job Responsibilities

• Quality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess coders’ comprehension and further assess ongoing education. Also assists in special project audits, as assigned.
• Educating - Assesses the educational needs of coding staff based on individual coder audit results and overall trends. Creates presentations, develops learning material, handbook and other educational materials. Edits/Denials/Coding - Assists operational coding team with initial coding, edits, and denials and appeals on an as needed basis.
• Training - Assists with training new and existing staff. Develops all training materials and coding aids for both formal training and use by coders in daily work. Identifies coders to be cross-trained and suggests areas for training improvement. Assists in the implementation and administration of effective systems, processes, and procedures.
• Resource - Serves as a technical resource for all involved personnel; ensures that information is accurate and current, meeting AMA, CMS, and professional coding standards. Performs miscellaneous job-related duties as assigned.
• Reporting - Provides reports of audit findings to coding management, individual coders and leadership as needed/requested along with providers that are contracted/employed and outlined in the client SOW. Assists with the creation of various documents and reports as requested. Immediately provides reports related to compliance risks when requested.

Experience We Love

• 5+ years of coding experience.
• 3+ years of auditing experience.
• Proficiency in multiple EMR’s, encoders, and the Microsoft Office suite.
• Educated in HIPAA regulations; must maintain strict confidentiality of patient and client information.
• Consistently achieves quality and productivity standards.
• Able to organize and complete work in a timely manner.
• Able to read, write and effectively communicate in English.
• Able to understand medical/surgical terminology.
• Above average written and verbal communication skills.
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.

Minimum Education

Associates degree or equivalent experience.

Required Certifications

• CPC (Certified Professional Coder)
• CPMA (Certified Professional Medical Auditor)
• CCS-P (Certified Coding Specialist-Phys Based)
• CCS (Certified Coding Specialist)
• CMPA (Certified Professional Medical Auditor)
• RHIA (Registered Health Information Administrator)
• RHIT (Registered Health Information Technician)

Remote Position

This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.

Employment Disclaimers

Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories. Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact TA@ensemblehp.com.

This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.