Coding Auditor

University of Utah HealthSalt Lake City, UT
Onsite

About The Position

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. The position audits and reports on the accuracy of procedural billing, payment consideration and accuracy in reimbursement based on the correct interpretation and application of codes, modifiers and payment rules. The incumbent reviews and audits physician and institutional billing from multiple departments and entities across the organization, and assists in training departmental personnel in correct coding and documentation. This position is not responsible for providing patient care. The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.

Requirements

  • Extensive knowledge of coding rules as outlined by CMS, AHA AMA.
  • Ability to identify areas or items which are not in compliance with the rules, present findings to various groups (e.g. physicians, nurses, administrators/directors coders, billing representatives) and recommend appropriate changes to policies and procedures.
  • Ability to meet the American Academy of Procedural Coders and/or AHIMA's continuing education requirements.
  • RHIA certification and two years of coding experience in multiple specialties, OR...
  • RHIT or CPC certification and four years coding experience in multiple specialties, OR...
  • Bachelor's degree in a health sciences related area, and
  • Four years of coding experience in multiple specialties.

Responsibilities

  • Performs audits and reports on the accuracy of procedure coding, facility E&M coding, ICD-9 coding and billing.
  • Reviews insurance payments for reimbursement accuracy, which is based on correct interpretation of clinical data and application of codes, modifiers and payment rules.
  • Reviews and audits institutional coding and billing from multiple departments and entities across the organization.
  • Assists in training personnel in correct documentation processes and coding guidelines.
  • Oversees on-going projects that are within the scope of this position.
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