Note: The job is a remote job and is open to candidates in USA. Carle Health is a healthcare organization committed to supporting patient care across central and southeastern Illinois. The Laboratory Coding Auditor/Educator oversees coding and charge integrity audits, provides coding education and training, analyzes billing data and denial trends, and supports laboratory leadership with regulatory compliance and accurate billing workflows.
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
Skills
- Must be able to perform essential job functions of Laboratory Billing & Coding Representative
- Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA)
- Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC)
- Highschool Diploma or G.E.D
- Coding
Benefits
- Remote work
- Potential for growth and life-long careers at Carle Health
- Comprehensive benefits package for team members and providers
Company Overview