Auditor Coding Specialist Remote

Trinity HealthCentral City, IA
Remote

About The Position

This is a Full-Time (80 hours biweekly) 100% Remote position for an Auditor Coding Specialist. The role requires a coding certification and a minimum of two years of current experience with ICDM 9, CPT coding, and health insurance provider rules and regulations. The specialist will be responsible for coding and abstracting patients’ records for professional billing, reviewing medical records retrospectively and concurrently for coding and sequencing of diagnoses and procedures for reimbursement purposes, and interacting with billers to assist with coding requests and questions. This role also serves as a resource for difficult coding questions and assists with insurance denials for correction and re-filing. The specialist will make process improvement recommendations to management, perform in compliance with federal, state, and insurance industry regulations, and follow established hospital policies concerning corporate compliance. Keeping abreast of insurance carrier rules and changes through education opportunities is also a key responsibility.

Requirements

  • Coding Certification required
  • Minimum of two years current experience with ICDM 9, CPT coding, and health insurance provider rules and regulations required.
  • High school diploma or GED required.
  • Knowledge of anatomy and physiology and medical terminology required.
  • Proof of completion of Mandatory Reporter abuse training specific to population served within three (3) months of hire.
  • Working knowledge of computer information systems required.
  • Demonstrates professional, appropriate, effective and tactful written, verbal, and nonverbal communication with patient, families, medical staff, colleagues, vendors, and other departments throughout the continuum of care to promote continuity of care and services and enhance department image.
  • Must be a self-starter and able to work independently and make appropriate decisions within hospital and departmental guidelines with little assistance from Manager.

Nice To Haves

  • One to two years post high school education preferred.
  • Knowledge of physician EM coding desired

Responsibilities

  • Responsible for coding and abstracting patients’ records for professional billing.
  • Reviews patient medical records retrospectively and concurrently for the coding and sequencing of diagnoses and procedures for reimbursement purposes.
  • Interacts and assists with coding requests and questions from billers.
  • Serves as a resource for difficult coding questions and assists with insurance denials for correction and re-filing.
  • Makes process improvement recommendations to management as identified, specifically related to registration and charge posting.
  • Performs in compliance with federal, state, insurance industry regulations.
  • Follows established hospital policies concerning corporate compliance.
  • Keeps abreast of insurance carrier rules and changes by participating in carrier specific and MCI education opportunities.
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