HIM Audit Specialist / PB Coding

Hartford HealthCare • Farmington, CT

89d

About The Position

The Audit Specialist is responsible for reviewing clinical documentation to determine appropriate coding assignment for ICD-10, HCPC and CPT for coding consistent with regulatory, contractual, professional standards and healthcare revenue cycle industry practices.

Requirements

• Minimum: High School Diploma
• Minimum: 3 years' work experience with CPT, HCPCS and ICD-10 coding conventions required.
• Minimum: Chart review of documentation of Evaluation and Management.
• Minimum: Experience with interpreting Medicare, Medicaid and third-party billing and compliance regulations necessary.
• Minimum: CPC, CCS-P, or CCS certification required and maintained thereafter.

Nice To Haves

• Preferred: Associates Degree
• Preferred: Experience working with CMS, health insurers strongly desired.
• Preferred: Experience auditing documentation preferred.
• Preferred: Experience with Word, Excel and PowerPoint required.
• Preferred: Knowledge of business systems, e.g., Epic, Healthicity, Intel Code preferred.
• Preferred: CPMA certification.

Responsibilities

• Analyze provider documentation for appropriate assignment of Evaluation and Management (EM) CPT, ICD-10, and modifiers.
• Audit charts assigned timely and efficiently providing feedback from the audit to the educators.
• Research literature from regulatory groups such as HHS/OIG, Medicare, Medicaid, NGS, etc., to keep organization current with regulatory requirements and accepted audit practices.
• Communicate with team members on findings from the chart audits to help support and create training material for the providers.
• Help support creating documentation templates designed for specialty/client, e.g., medical reports, monitoring/analysis reports, continuous auditing tools, etc.
• Identify common documentation and coding issues and process improvement and effectively communicate with team the findings.

Benefits

• Competitive benefits program designed to ensure work/life balance.

What This Job Offers

• Industry: Religious, Grantmaking, Civic, Professional, and Similar Organizations
• Education Level: High school or GED