Overview Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise. Join our team as the expert you are now and create your future. Responsibilities Knows, understands, incorporates, and demonstrates Huron’s Vision, and Values in behaviors, practices, and decisions. Coding Auditor Responsible for the auditing of coders and/or auditing the auditors to ensure coding accuracy of a minimum of 95% is met. Perform quality checks/audits on visits coded as per client SOPs. Perform calibration audits. Suggest improvements and schedule calibration sessions with offshore team counterparts and leaders. May assist in preparing audit reports, share direct feedback to coders and auditors on areas of opportunity, participate in client interactions and internal stakeholder meetings. Firm understanding of the clinical documentation guidelines. Monitor compliance of coding guidelines and ensure errors identified during audits are corrected as appropriate, and corrective action is initiated before the claim is rebilled to the insurer. Conduct analysis and present summary of findings to leadership in a clear, concise, convincing, and actionable format. Utilizes encoder software applications, which includes all applicable online tools and references. Assigns appropriate code(s) by utilizing coding guidelines established by: The Centers for Disease Control (CDC), ICD-CM Official Coding Guidelines for Coding and Reporting, Centers for Medicare/Medicaid Services (CMS) ICD-CM Official Guidelines for Coding and Reporting American Hospital Association (AHA) Coding Clinic for ICD/CM The American Medical Association (AMA) for CPT codes and CPT Assistant American Health Information Management Association (AHIMA) Standards of Ethical Coding Client coding procedures and guidelines Navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes. Meets the productivity standards for coding auditing as per ambulatory coding standards. Maintains a high degree of professional and ethical standards. Focuses on updating coding skills, knowledge, and accuracy by participating in coding team meetings and educational conferences. Maintains CEUs as appropriate for coding credentials as required by credentialing associations. Maintains current knowledge of changes in ambulatory/professional coding and reimbursement guidelines and regulations. Ensure patient information is correct and appropriate signatures are on all medical records. Demonstrates knowledge of current, compliant coder query practices when consulting with physicians, Clinical Documentation Specialists (CDS) or other providers when additional information is needed for coding and/or to clarify conflicting or ambiguous documentation. Utilizes EMR communication tools to track missing documentation or ambulatory queries that require follow-up to facilitate coding in a timely fashion. Works with HIM and Patient Financial Services (PFS) teams, when needed, to help resolve billing, claims, denial and appeals issues affecting reimbursement. Identifies and attempts to problem solve coding and/or EMR workflow issues that can impact coding. Exhibits awareness of health record documentation or other coding ethics concerns. Notifies appropriate leadership for assistance and resolution when appropriate. Maintains a working knowledge of applicable coding and reimbursement federal, state and local laws and regulations, code of ethics, and other policies to ensure ethical and professional behavior. May require abstraction of additional data elements. Perform other duties as assigned. Core Qualifications Current permanent United States work authorization required Day shift schedule required in the United States Experience in coding specialties such as E/M, Oncology, Acute, Ambulatory, Cardiology, Radiology, Pathology, Anesthesia, Emergency Room, Surgery, and others 2+ years previous experience as a professional/profee/ambulatory coding auditor 3+ years of experience coding professional/profee/ambulatory accounts Advanced proficiency with Microsoft Office suite (Excel, Word, PowerPoint, Outlook, Visio, SharePoint) Analytical skills (problem solving, quantitative, workflow process, etc.) Attention to detail with strong follow-up and follow-through skills Excellent time management skills; organized; ability to prioritize multiple tasks in a deadline-driven environment Independent judgment, discretion and decision-making abilities Ability to interact with internal and external customers professionally Ability to ramp up on a client’s environment, processes, historical context, and systems to provide support quickly Financial acumen and analytical skills are required Experience working with data from various sources is preferred Familiarity with revenue cycle systems and understanding of revenue cycle process flow and financial analysis Desire to work as part of a team in a partnership role Strong oral and written communication skills, ability to work independently, and self-motivation Flexible and adaptable to change Physical Demands This role requires remaining seated at a desk/computer for 8 hours daily; repetitive use of keyboard and mouse; use of monitors for 8 hours daily; interaction through video/audio conference calls; may include use of a headset with microphone; very rarely may require lifting up to 20 pounds and bending/standing for periods of time. Technical Qualifications Required Certifications: Certified Professional Coder (CPC) through AAPC Preferred Certifications: AAPC CPMA (Certified Professional Medical Auditor) RHIA preferred Encoder experience (3M/Solventum, Encoder Pro, Codify) preferred Epic, Cerner, and Meditech experience preferred Key Performance Indicators (KPIs) – Expectations Coding Auditing Productivity: ≥ 95% Coding Auditing Accuracy: ≥ 95% The estimated pay range for this job is $26.44 - $37.50 per hour. The range represents a good faith estimate of the range that Huron reasonably expects to pay for this job at the time of the job posting. The actual salary paid to an individual will vary based on multiple factors, including but not limited to specific skills or certifications, years of experience, market changes and required travel. This job is eligible to participate in Huron’s benefit plans which include medical, dental and vision coverage and other wellness programs. The pay range information provided is in accordance with applicable state and local laws regarding salary transparency that may be implemented in the future. Position Level Analyst Country United States of America Huron is fully committed to providing equal employment opportunities to job applicants and employees in recruitment, hiring, employment, compensation, benefits, promotions, transfers, training, and all other terms and conditions of employment. Huron will not discriminate on the basis of age, race, color, gender, marital status, sexual orientation, gender identity, pregnancy, national origin, religion, veteran status, disability, genetic information, creed, citizenship or any other status protected by laws or regulations. We maintain a drug-free workplace. #J-18808-Ljbffr