Department/Unit: Health Information Management
Work Shift: Day (United States of America)
Salary Range: $60,367.47 - $90,551.20
We are seeking a skilled Professional Coding Auditor to join our Health Information Management team. In this role, you will leverage your advanced coding expertise to lead a service line coding team. Collaborate with others to ensure comprehensive and timely professional coding processes, including coding, charging, and managing denials follow-up. You will audit CPT and ICD-10 diagnosis coding performed by providers and coding staff, ensuring compliance with federal and state laws as well as insurance carrier guidelines. This remote position also requires onsite educational support for providers when necessary.
Key Responsibilities:
- Review, analyze, and validate CPT and ICD-10 diagnosis codes ensuring adherence to various regulations and guidelines.
- Assist in daily operations and act as a Team Lead, guiding staff to meet quality and productivity standards.
- Supervise coding staff in the absence of the Supervisor and participate in recruitment processes.
- Streamline coding accuracy by proposing coding/edit rules and participating in testing workflows.
- Provide training and orientation to new staff, ensuring compliance with established protocols.
- Conduct audits to review billing integrity, assess documentation compliance, and identify areas for clinical documentation improvement.
- Analyze audit findings to formulate training recommendations and corrective actions.
- Support Denials Management efforts by identifying root causes and training providers/staff to mitigate future issues.
- Facilitate external audit processes and implement necessary changes based on findings.
- Engage in continuous professional development through webinars, workshops, and conferences.
- Perform other duties as assigned to contribute to department operations.
Qualifications:
- High School Diploma/G.E.D. required.
- A minimum of two years of professional fee coding experience required.
- Preferred knowledge in multiple coding specialties.
- Strong understanding of provider professional fee coding and charge processing.
- Proficient in Microsoft Word and Excel, with excellent verbal and written communication skills.
- Must possess CPC, CCA, CCS, COC, RHIT, or RHIA certification upon hire.
Thank you for considering a career with Albany Medical Center! We are proud to be an equal opportunity employer, committed to fostering a diverse workforce.
This position may require access to sensitive information. Employees are expected to ensure that access is based on necessity and to protect all information from unauthorized access and modification.