Auditor/Education Liaison-2 (MBD)

Memorial Hermann Health System • Knoxville, TN

1d

About The Position

Responsible for ensuring the accuracy and completeness of clinical coding that results in appropriate reimbursement and data integrity and validation of the coded information for external and internal sources. The incumbent will audit to ensure that professional services documentation accurately reflects compliance with published guidance, policies, procedures, coding and reimbursement rules. Monitoring for changes in laws, rules, regulations, and code assignments that impact documentation and reimbursement is implicit. Identify, document and present any errors, irregularities or findings to physicians, senior management and staff. Serve as a resource/subject matter expert in regards to clinical compliance related issues, billing and coding rules and regulations, and interpret and communicate federal and state guidance/laws.

Requirements

• High school diploma or GED, required
• Certified Risk Adjustment Coder (CRC) from the American Academy of Professional Coders (AAPC)
• Certified Professional Coder (CPC) from the American Academy of Professional Coders (AAPC)
• Certified Coding Specialist (CCS) from the American Health Information Management Association (AHIMA)
• Registered Heath Information Technician (RHIT) from the American Health Information Management Association (AHIMA)
• Registered Health Information Administrator (RHIA) from the American Health Information Management Association (AHIMA)
• Three (3) years of hospital or physician coding experience
• Extensive knowledge of ICD-10 CM, CPT4, HCPCs and modifiers principles and guidelines
• Extensive knowledge of reimbursement systems and regulations and policies pertaining to documentation and coding
• Knowledge of spreadsheet design
• Proven team player sensitive to organizational dynamics.

Nice To Haves

• Associates degree in healthcare related field preferred
• One year HCC experience
• Minimum one (1) year auditing experience in either hospital or physician auditing
• 6 months HCC auditing

Responsibilities

• Conducts regular coding audits and coordinates ongoing monitoring of coding accuracy, providing continuous feedback to coding staff.
• Serves as a resource for coding staff on organization-wide coding and documentation standards and guidelines.
• Keeps abreast of coding guidelines and reimbursement reporting requirements.
• Conducts trend analyses to identify patterns and variations in coding practices.
• Follow coding compliance policies, official coding guidelines, regulatory requirements and internal policies and procedures affecting the coding process.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines.
• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
• Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences.
• Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
• Other duties as assigned.

Benefits

• delivering high quality, efficient care while creating exceptional experiences for every member of our community
• employees feel cared for, heard and valued
• advance your career
• contribute to our vision of creating healthier communities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees