Certified Coder and Auditor

Avita Health System•Crestline, OH

18h•Onsite

About The Position

Avita Health System is seeking a Certified Coder & Auditor to join their Patient Financial Services Department at their Crestline location. This role involves taking a guiding role in the orientation and ongoing education of the professional coding team, physicians, and advanced practice providers (APPs) involved in the coding and documentation process. The position ensures accuracy by conducting audits, analyzing chart documentation, and providing reeducation and training when necessary. The Certified Coder & Auditor will serve as a knowledge source for coding guidelines, CMS, federal and state coding regulations, and third-party reimbursement requirements. The role is responsible for converting and auditing documentation of diagnosis, procedures, and utilized supplies and devices for assigned physicians and APPs using ICD-10, CPT, and HCPCS guidelines. They will act as a coding resource for assigned providers and clinic managers and collaborate with the follow-up team to overturn and avoid denials.

Requirements

High School graduate or equivalent.
Professional Coding Certification (CPC, CCS-P).
At least two (2) years of experience analyzing and providing feedback on physician documentation and performing coding audits.
Fully knowledgeable of, and conducts all activities in accordance with regulatory compliance requirements, including but not limited to HIPPA rules and regulations, Medicare Secondary Payer Screening requirements, medical necessary screening and ABN rules, Red Flag Rules, and billing and coding compliance rules and regulations.

Nice To Haves

Certified Professional Medical Auditor (CPMA) and Certified Risk Adjustment Coder certification.
Associate’s or bachelor’s degree in health administration, health information management, or related field or pursuit of an advances degree.
Previous coding education/training experience.
Previous billing experience and demonstrates knowledge of third party and self-pay billing procedures and claim review and analysis.

Responsibilities

Takes a guiding role in the orientation and ongoing education of professional coding team, physicians, and advanced practice providers (APPs) involved in the coding and documentation process.
Ensures the accuracy of information in these processes is maintained by conducting audits and analyzing chart documentation and, if accuracy is not at the expected level, reeducates and trains providers and staff.
Serves as knowledge source as it related to coding guidelines; CMS, federal, and state coding regulations; and third party reimbursement requirements.
Responsible for converting and auditing documentation of diagnosis, procedures, and utilized supplies and devices for assigned physicians and APPs using ICD-10, CPT, and HCPCS guidelines.
Acts as a coding resource for assigned providers and clinic managers.
Collaborates with the follow-up team to overturn denials and avoid future denials.