[Hiring] HIM Coding Auditor @UHS

Role Description

The Coding Auditor is responsible for determining that ICD-10, CPT-4, and HCPCS coding is supported by the clinical documentation in the medical record as well as validating medical necessity per CMS Local Coverage Determination (LCD). Applies working knowledge of medical terminology, anatomy, CPT-4 and ICD-10 codes and coding skills/experience to ensure timely and accurate audits of clinical documentation as requested.

• Performs accurate and timely review of clinical documentation as requested to ensure that ICD-10, CPT-4 and HCPCS coding is supported by the clinical documentation in the medical record.
• Meets or exceeds established performance targets (productivity and quality) established by the Manager, Coding.
• Reviews audit samples following CBO IPM policy and utilizing established protocols, audit tools and worksheets to report accurate and timely findings to the Coding Manager.
• Assists in educating providers on clinical documentation requirements to support their coding and ensure all coding (charge) possibilities are being captured.
• Provides feedback on audit and education plans and materials and makes recommendations for updates that will enhance the auditing process.
• Maintains an expanded knowledge base of CPT-4 and ICD-10 codes, government, managed care and third party billing guidelines, AMA, AAP, CMS and coding policies.
• Exercises good judgement in escalating identified coding trends that may negatively impact productivity, quality or revenue.
• Participates in regularly scheduled team meetings offering new paths, procedures and approaches to maximize opportunities for performance and process improvement.

Qualifications

• High School Graduate/GED required. Associates Degree preferred.
• 3 - 5 years of experience required working in a healthcare (professional) billing, health insurance, coding, auditing or equivalent operations work environment.
• Auditing experience required.
• AAPC CPC Certification required.
• Understanding of the revenue cycle and how the various components work together preferred.
• Excellent organization skills, attention to detail, research and problem solving ability.
• Results oriented with a proven track record of accomplishing tasks within a high-performing team environment.
• Service-oriented/customer-centric.
• Strong computer literacy skills including proficiency in Microsoft Office.
• Billing software (e.g., Cerner, Epic, IDX) experience are highly desirable.

Requirements

• Coder Certification Required.
• Successful candidate must live in one of these locations: Pennsylvania, Delaware, Florida, Nevada, New Jersey, Texas.

Benefits

• Challenging and rewarding work environment.
• Competitive Compensation & Generous Paid Time Off.
• Excellent Medical, Dental, Vision and Prescription Drug Plans.
• 401(K) with company match and discounted stock plan.
• Career development opportunities within UHS and its 300+ Subsidiaries!
• Pet Insurance.