Providence Health & Services Coding Auditor and Education Specialist in Spokane Valley, Washington
Providence is calling a Coding Auditor and Education Specialist PSJH to Providence Health & Services in Spokane, WA.
We are seeking a Coding Auditor and Education Specialist PSJH to audit medical records to ensure compliance with the organization's coding procedures and standards. Reviews insurance payments and denials and recommends billing corrections. Serves as a coding expert, working with the Coding Supervisor/Manager and the Clinical Documentation Improvement Program (CDIP) Data Integrity Liaison to ensure compliance with Official Coding Guidelines for Coding and Reporting, coding conventions and regulatory oversight agencies.
In this position you will have the following responsibilities:
Assess, develop resources/materials, and conducts training to assure accurate coding of Health Information Management (HIM) coded medical records
Be responsible for monitoring and overseeing the coding integrity program
Develop competencies and quality assessment tools for education/compliance requirements
Conduct chart audits for physician documentation requirements & internal coding; provide associate/physician & education as appropriate
Review and revise departmental policies and provides education to coding staff regarding changes
Assist with the development and implementation of policies, procedures, standards and initiatives
Serve as Epic super-user and recommends system modifications to improve the organization’s coding functions
Develop and revise educational objectives and curriculum applicable to all Epic coding processes
Assist with developing goals, standards, and objectives that directly support the strategic plan and vision of the organization
Provide positive feedback in a constructive manner
Develop and maintain good working relationships with peers, physicians and other staff members
Work in a high volume environment while maintaining high quality standards
Adhere to established company compliance, policies, procedures and protocols
Required qualifications for this position include:
High School diploma or equivalent
5 years experience in medical insurance reimbursement, medical billing, and coding related to charge review and work RVU’s.
Certification: Required Certified Professional Coder (CPC credential) or Registered Health Information Technician (RHIT) or holds at least one of the following coding credentials from the American Academy of Professional Coders (AAPC) and/or American Health and Information Management Association (AHIMA):
Registered Health Information Management Technician (RHIT)
Certified Coding Specialist (CCS)
Certified Coding Associate (CCA)
Certified Coding Specialist – Physician Based (CCS-P)
Certified Professional Coder (CPC)
Certification: Current BLS – Healthcare Provider (must be AHA accredited) or obtained within 90 days of hire
Extensive knowledge of CMS E&M documentation requirements
The ability to research and audit provider charges to ensure they are properly processed
Experience with provider and clinic staff feedback and education
Extensive knowledge of: medical terminology, CPT, ICD-10 and HCPCS coding
Experienced in reviewing patient account information, insurance explanation of benefits, computer screens, and financial records
Proficient with computer and data processing
Strong analytical, problem solving and written and oral communication skills
Advanced knowledge of coding principles for disease management process, Medicare Risk Adjustment scores and Medicare fee for scenarios
Demonstrated ability to mentor and motivate staff, identify and implement process improvement
Ability to effectively communicate to patients, customers, co-worker or leaders via written or verbal communication
Exhibit a high level of professionalism in all communication with all customers, both internal and external
Preferred qualifications for this position include:
Associates degree or higher
Previous experience teaching documentation guidelines to Providers
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Coding
Location: Washington-Spokane Valley
Req ID: 188685