Note: The job is a remote job and is open to candidates in USA. Holy Cross Health is a Catholic, not-for-profit health system that serves over 240,000 individuals each year. The Professional Coding Auditor & Educator performs medical record audits, ensuring proper assignment of diagnosis and procedure codes while providing education to practitioners about coding and compliance.
Responsibilities
- Monitors accuracy of centralized coders’ charge capture and coding with proper ICD-10, CPTs, as well as proper modifiers, adhering to local ministry and Trinity practices and policies
- Partners with leadership to improve HCC, high risk scoring, with provider and coder education
- Conducts ongoing reviews of patient medical record documentation and procedural and diagnosis coding by each practitioner
- Responsible for practitioner education in areas related to coding, documentation, and compliance
- Works closely with leadership and the department to establish and modify the charge description master (CDM) methodology and pricing models to ensure accuracy and regulatory compliance
- Reports to the Manager, Provider Revenue Operations
Skills
- High school diploma or equivalent combination of education and experience
- Certified Professional Coder or Registered Health Information Technician accreditation required
- Minimum of 2-5 years of professional coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCs modifiers
- Knowledge of Medicare, Medicaid, and other third-party billing rules and regulations
- Effective verbal, written, and interpersonal communication skills with the ability to comfortably interact with diverse populations
- Ability to work collaboratively in a team-oriented environment with a strong customer-service orientation
- Ability to handle patient and organizational information in a confidential manner
- Ability to demonstrate competency with a standard desktop and Windows-based computer system, including a basic understanding of email, e-learning, intranet and computer navigation
- Ability to use other software as required to perform the essential functions of the job
- Demonstrated dependability and regular attendance
- Solid understanding of ICD-10 and CPT coding and medical terminology, with knowledge of Medicare, Medicaid, Health Maintenance Organization and commercial insurance plans
- Ability to exercise independent judgment as appropriate within standard practices and procedures
- 3-6 years of professional coding experience; ability to code from operative reports; prior auditing experience
Benefits
- Tuition reimbursement
- Free parking
- Employee discounts
- Flexible work schedules
- Professional growth within the organization
Company Overview