Solid Organ Transplant Coding Auditor

University of Utah Health • Salt Lake City, UT

22h

About The Position

The position audits and reports on the accuracy of procedural billing, payment consideration, and 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.

University of Utah Health is a patient-focused organization whose mission is to enhance health and well-being through patient care, research, and education. The organization emphasizes collaboration, excellence, leadership, respect, compassion, innovation, responsibility, integrity, quality, and trust. The University of Utah is a Level 1 Trauma Center with five hospitals and eleven clinics.

Requirements

• Extensive knowledge of coding rules as outlined by CMS, AHA, and AMA.
• Ability to identify items or areas that are not compliant with coding rules, present findings to groups such as physicians, nurses, administrators/directors, coders, and billing representatives, and recommend appropriate policy and procedure changes.
• Ability to meet the American Academy of Procedural Coders and/or AHIMA continuing education requirements.
• One of the following qualification paths: RHIA certification and two years of coding experience in multiple specialties; or RHIT or CPC certification and four years of coding experience in multiple specialties; or a bachelor's degree in a health sciences-related area and four years of coding experience in multiple specialties.

Nice To Haves

• Knowledge of inpatient and outpatient transplant- or specialty-related billing, claims, coding, and review.
• Knowledge of transplant and Medicare cost reporting.

Responsibilities

• Performs audits and reports on the accuracy of procedure coding, facility E&M coding, ICD-10 coding, and billing.
• Reviews insurance payments for reimbursement accuracy 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 ongoing projects within the scope of the position.
• Identifies noncompliance with coding rules, presents findings to relevant groups, and recommends appropriate changes to policies and procedures.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level