[Hiring] Coding Auditor/Educator @Carle Health

Role Description

The Laboratory Coding Auditor/Educator assists with oversight of coding audits and delivers targeted education for the Laboratory Billing & Coding Representatives, Pathologists, and applicable departments. This role works closely with and supports Laboratory leadership to ensure regulatory and compliance requirements are met for appropriate code assignment, while serving as a senior coding resource for the department. The Auditor/Educator conducts billing workflow and charge integrity audits to ensure laboratory orders and charges accurately transmit to EPIC. The Auditor/Educator adheres to all duties of the Laboratory Billing & Coding Representative.

Responsibilities

• Must be able to perform essential job functions of Laboratory Billing & Coding Representative.
• Assists Laboratory Revenue Integrity & RCM Manager in managing audits and audit schedules.
• Provides coding audits to Laboratory Coding & Billing Representatives and Pathologists specific to CPT, HCPCS, modifier, and place of service coding.
• Provides education as needed, either one-on-one or group format to team members and Pathologists.
• Provides billing workflow and charge integrity audits to ensure laboratory orders and charges accurately transmit to EPIC.
• Compiles and tracks statistics related to the audit process.
• Serves as senior coding resource for department.
• Responsible for training new billing staff in laboratory coding and billing practices.
• Attend meetings as required with Pathologists, LIS, Revenue Cycle, and HIM on topics related to coding and auditing.
• Supports manager by interpreting and analyzing billing data to identify and monitor performance and established benchmarks for the department.
• Maintains knowledge of current and required coding regulations and assures team members are updated as regulations change.
• Trends coding-related denials, identifies root causes, and advises leadership on opportunities to resolve trends.
• Builds collaborative relationships with laboratory departments, pathologists, LIS, Revenue Cycle Systems, and other departments to support accurate system configuration.
• Tracks and trends all role functions for reporting purposes.
• Meet with Manager of Laboratory Revenue Integrity & RCM to review audits and attend meetings as required on topics related to coding and auditing education needs and follow up.
• Work with Laboratory Leadership to establish coding guidelines and assure coding team audits are completed timely.
• Report compliance or other concerns directly to Laboratory Leadership as needed or indicated.

Qualifications

• Certifications: Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA); Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC)

Salary Range

The compensation range for this position is $25.18 per hour - $42.05 per hour. This represents a good faith minimum and maximum range for the role at the time of posting by Carle Health. The actual compensation offered a candidate will be dependent on a variety of factors including, but not limited to, the candidate’s experience, qualifications, location, training, licenses, shifts worked and compensation model.

Benefits

Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org/benefits .