Coding Auditor (Hybrid), Day Shift, Revenue Integrity

Adventist HealthCare•Gaithersburg, MD

2d•$27 - $39•Hybrid

About The Position

Adventist Healthcare seeks to hire an experienced Coding Auditor for our Revenue Integrity department who will embrace our mission to extend God’s care through the ministry of physical, mental, and spiritual healing. As a Coding Auditor, you will: Leads discussions and educational sessions, with manager support, with various impacted 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 Performs root cause analyses on trends and systemic barriers and presents findings to leadership Assesses Present on Admission (POA) indicators at AHC facilities Communicate with clinical practices and providers in a productive and professional manner Provide 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.

Requirements

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.
Understands and can apply CMS rules and regulations
Understanding and compliance with HIPAA laws and regulations
Understand 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
3+ years of coding experience in a hospital or medical practice setting
Certified in CCS, CCS-P, or CPC

Nice To Haves

RHIA, RHIT preferred.

Responsibilities

Leads discussions and educational sessions, with manager support, with various impacted 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
Performs root cause analyses on trends and systemic barriers and presents findings to leadership
Assesses Present on Admission (POA) indicators at AHC facilities
Communicate with clinical practices and providers in a productive and professional manner
Provide 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.

Benefits

Work life balance through nonrotating shifts
Recognition and rewards for professional expertise
Free Employee parking
Medical, Prescription, Dental, and Vision coverage for employees and their eligible dependents effective on your date of hire
Employer-paid Short & Long-Term Disability, Basic Life Insurance and AD&D, (short-term disability buy-up available)
Paid Time Off
Employer retirement contribution and match after 1-year of eligible employment with a 3-year vesting period
Voluntary benefits include flexible spending accounts, legal plans, and life, pet, auto, home, long term care, and critical illness & accident insurance
Subsidized childcare at participating childcare centers
Tuition Reimbursement
Employee Assistance Program (EAP) support