Solid Organ Transplant Coding Auditor

University of Utah Health • Salt Lake City, UT

1d

About The Position

University of Utah Health seeks staff committed to collaboration, excellence, leadership, respect, and the organization’s values of compassion, innovation, responsibility, integrity, quality, and trust. The Solid Organ Transplant Coding Auditor audits and reports on procedural billing accuracy, payment consideration, and reimbursement accuracy through correct interpretation and application of codes, modifiers, and payment rules. The position reviews and audits physician and institutional billing across multiple departments and entities and assists departmental personnel with correct coding and documentation training. The role does not provide patient care.

The position also oversees ongoing projects within its scope. It is sedentary, involves sitting most of the time, may require moving objects weighing up to 10 pounds, and is not exposed to adverse environmental conditions. The employee must be able to meet the stated requirements with or without accommodation.

Requirements

• Extensive knowledge of coding rules as outlined by CMS, AHA, and AMA.
• Ability to identify areas or items that are not compliant with coding rules.
• Ability to present findings to physicians, nurses, administrators/directors, coders, and billing representatives, and recommend appropriate changes to policies and procedures.
• Ability to meet the American Academy of Procedural Coders and/or AHIMA continuing education requirements.
• One of the following: RHIA certification and two years of coding experience in multiple specialties; 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

• Audit and report on the accuracy of procedure coding, facility E&M coding, ICD-10 coding, and billing.
• Review insurance payments for reimbursement accuracy based on clinical data and the correct application of codes, modifiers, and payment rules.
• Review and audit institutional coding and billing from multiple departments and entities across the organization.
• Assist personnel with correct documentation processes and coding guidelines.
• Oversee ongoing projects within the scope of the position.
• Identify coding or billing noncompliance, present findings to relevant groups, and recommend appropriate changes to policies and procedures.

What This Job Offers

• Job Type: Full-time