Coding Auditor and Educator Job Chicago area,Illinois USA,Healthcare

Job Description

Location:

Chicago, Illinois

Business Unit:
Rush Medical Center

Hospital:
Rush University Medical Center

Department: PB Revenue Integrity

Work Type: Full Time (Total FTE between 0.9 and 1.0)

Shift: Shift 1

Work Schedule: 8 Hr (7:00:00 AM - 3:00:00 PM)

Rush offers exceptional rewards and benefits learn more at our Rush benefits page https://(Use the "Apply for this Job" box below)..

Pay Range: $32.00 - $52.08 per hour

Rush salaries are determined by many factors including education, job-related experience, and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush’s anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case.

Summary

As a key role in the Revenue Integrity team, the Auditor & Educator is responsible for conducting reviews of EMR documentation of patient encounters to ensure coding accuracy and documentation adequacy. The professional will work collaboratively with clinical 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.

Provide feedback and focused educational programs on the results of auditing, review claim denials pertaining to coding, and implement corrective action plans. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.

Required Job Qualifications

Associate's degree in health information management, other related field, or 3 years of relevant experience
Certified Professional Coder (CPC) or Certified Coding Specialist
- Physician Based (CCS-P)
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 or CCS-P certification being acquired within the first 6 months of employment.
Three years of E/M and/or surgical coding experience.
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.
Strong communication and organizational skills.

Preferred Job Qualifications

Certified Professional Medical Auditor (CPMA) and/or Surgical Coding certifications
Experience working in a Teaching Hospital setting.
Prior experience with billing and claims processing.
Prior experience working in a hospital or clinical setting.
Proficient in Excel, Word, Data Entry, computerized health care billing software knowledge, experience in Epic Ambulatory.

Responsibilities

Coordinates, schedules, and performs reviews of professional services and documentation performed by RUMG & ROPPG providers.

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 for both providers and coders for appropriate CPT, ICD-10, and modifiers based on supporting documentation and EMR charge capture support.

Serves as a liaison point of contact for clinical coding inquiries and communication for professional billing revenue cycle.

Seeks to…


Increase/decrease your Search Radius (miles)



Job Posting Language