AUDIT INTEGRITY - MEDICAL CODING AUDITOR

MOUNTAIN VIEW HOSPITAL LLC • Idaho Falls, ID

1d • Onsite

About The Position

Mountain View Hospital is looking for a Medical Coding Auditor to join our team! The Medical Record Auditor will be responsible for assisting/conducting audits of medical records, coding and billing information. The auditor will look at both departments inside the hospital, outside departments and physician records and billing. Auditors will put together informational reports of finding and relay the information to the appropriate source. Reporting will be generated to help track which providers, locations or target areas need to be audited. The medical auditor will assist in putting together appeals/ rebuttals for external auditing sources. Auditor should have audits completed within a timely manner that is set up with the supervisor/ manager. Auditor will be provided as education as directed by the Auditing Integrity Department manager. Works collaboratively with the unit-specific educators, department manager, department supervisor, the DON and the compliance team to support in assessing, planning, implementing and evaluating educational activities for all postpartum staff; specifically focusing on nursing and clinical aspects. Assists with and oversees general, clinical, and nursing orientation as well as professional development including in-services and continuing education. The roles of the educator include: educator, facilitator, change agent, collaborator, advisor, mentor, consultant, researcher, and leader.

Requirements

• High School Diploma or GED
• Certified Professional Coding Certificate or Certified Professional Auditing Certificate
• Minimum of 3 years of coding experience.
• Working knowledge of CPT, ICD-10-CM, ICD-10-PCS, HCPCS.
• Can concentrate for long periods of time in order to complete assigned tasks with a better than average attention span in order to listen, read and remember verbal and written instructions.
• Can understand input from the supervisor and/or manager concerning errors and instructions.
• Must be able to handle conflict issues with both staff and providers.
• Hold oneself to high standards and professionalism while performing audits and providing education.

Responsibilities

• Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT, ICD-10 and HCPCS coding to these services.
• Contacts physicians through management regarding procedures and other services billed to ensure proper coding.
• Responsible for reviewing patient logs and other reports of clinical activity to ensure billing is capture for all patients.
• Monitors and follow up to ensure all services that can billed are captured and coded for billing and no charges are incorrectly charged.
• Reviews all physician documentation to ensure compliance with the third party and regulatory guidelines.
• Works in conjunction with the reimbursement staff to answer all inquiries regarding coding and billing for services.
• Works in coordination with the other members of the business office as necessary.
• Meets and exceeds the short and long term goals as established for the department.
• Performs duties and job functions in accordance with the policies and procedures established for the department.
• Reports to work, meetings and professional obligations on time.
• Participates in administrative staff meetings and attends other meetings and seminars.
• Assists in evaluation of reports, decisions and results of department in relation to established goals.
• Recommends new approaches, policies and procedures to influence continuous improvement in the departments efficiency and services provided.
• Takes ownership of special projects, researches data and follows through with detail action plans.
• Actively participates in problem identification and resolution and coordinates resolution between the appropriate parties.
• Performs other related duties as required and assigned.
• Uses outcomes management computerized information systems to statistically analyze outcomes data including practice patterns.
• Compiles data into reports for the manager or committee including and analysis of trends and patterns.
• Fulfills internal and external requests for outcome data, including developing special reports.
• Participates in presentations to educate staff on outcomes and plans of correction.
• Collaborates with the clinical team to use outcomes data in education.
• Helps train clinicians or other staff on new protocols.

Benefits

• Medical, Dental and Vision Insurance
• Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off
• Retirement Plans (401K with up to 6% match)
• Earned Quarterly Bonus Program
• Education Reimbursement Program
• Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED