Coding Auditor (Hybrid), Day Shift, Revenue Integrity

About the role

Adventist Healthcare's Support Center seeks to hire an experienced Coding Auditor for our Revenue Integrity department. The role involves leading discussions and educational sessions with various Revenue Integrity stakeholders to improve overall revenue goals and departmental needs. Key responsibilities include analyzing and resolving billing edits and bill holds, managing work queues, escalating issues, performing EHR analyses, conducting root cause analyses, and communicating with clinical practices and providers.

Responsibilities

• Leads discussions and educational sessions with various Revenue Integrity stakeholders to improve overall revenue goals and departmental needs.
• Analyzes and resolves billing edits and bill holds for areas impacted by coding.
• Manages assigned work queues and associated tasks to review, analyze, and provide corrective action.
• Maintains work queues at agreed-upon levels to keep on task with department goals and objectives.
• Escalates barriers or concerns to the manager in a timely, clearly articulated, and documented format.
• Performs EHR analyses and research along with associated patient accounting, medical charting, and system interfacing to examine and understand underlying root causes of charge capture delays and reconciliation challenges.
• Conducts root cause analyses on trends and systemic barriers and presents findings to leadership.
• Assesses Present on Admission (POA) indicators at AHC facilities.
• Communicates with clinical practices and providers in a productive and professional manner.
• Provides support to the Director, Manager, and Coordinators in their efforts to collaborate with AHC entities, physicians, physician practices, CMOs, CDI, and other stakeholders in understanding the impact of coding on care quality, documentation, and reimbursement.

Qualifications

• Extensive knowledge of ICD-10, CPT coding, Evaluation and Management Codes, modifiers, Coding Clinic and CPT Assistant.
• Experience with Denials Management as it pertains to coding experience and assessing related denials.
• Working knowledge of anatomy, medical and procedural terminology.
• Strong knowledge of medical billing practices.
• Familiarity with bill hold edits for coding concerns and questions.
• Extensive knowledge of 3M Encoder.
• Proficiency in Microsoft Office, including Outlook, Word, PowerPoint, and Excel; fluency in Cerner and/or eCW is desirable.
• Strong attention to detail and accuracy, using problem-solving skills and analytical thinking.
• Understanding and can apply CMS rules and regulations.
• Understanding and compliance with HIPAA laws and regulations.
• Understanding and applying query practice and guidelines and appropriate ways to communicate with coding vendors, other coding expertise, and clinicians.
• Strong experience with patient accounts audits and accuracy are required.
• Good organizational, written, and verbal communication skills.
• Ability to perform comfortably in a fast-paced, deadline-oriented work environment.
• Ability to work as an independent contributor.
• High School or GED with 3+ years of coding experience in a hospital or medical practice setting.
• Certified in CCS, CCS-P, or CPC RHIA, RHIT preferred.

Work Schedule

Full-time, 40 hours per week, Day Shift/Hybrid Shift Type.

Pay Range

$26.91 - $39.03

COVID-19 Vaccination

Adventist HealthCare strongly recommends all applicants to be fully vaccinated for COVID-19 before commencing employment. Applicants may be required to furnish proof of vaccination.

Tobacco and Drug Statement

Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, Adventist HealthCare will not hire applicants for employment who either state that they are nicotine users or who test positive for nicotine and drug use. While some jurisdictions, including Maryland, permit the use of marijuana for medical purposes, marijuana continues to be classified as an illegal drug under the federal Controlled Substances Act. As a result, medical marijuana use will not be accepted as a valid explanation for a positive drug test result. Adventist HealthCare will withdraw offers of employment to applicants who test positive for Cotinine (nicotine) and marijuana. Those testing positive are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing.

Equal Employment Opportunity

Adventist HealthCare is an Equal Opportunity/Affirmative Action Employer. We are committed to attracting, engaging, and developing the best people to cultivate our mission-centric culture. Our goal is to have a welcoming, equitable, and safe place to work and grow for all employees, no matter their background. AHC does not discriminate in employment opportunities or practices on the basis of race, ethnicity, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, pregnancy and related medical conditions, protected veteran status, or any other characteristic protected by law. Adventist HealthCare will make reasonable accommodations for applicants with disabilities, in accordance with applicable law. Adventist HealthCare is a religious organization as defined under applicable law; however, it will endeavor to provide reasonable accommodations for applicants’ religious beliefs.