Coding Compliance Auditor

Company: Children's Hospital & Medical Center - Omaha
Location: Omaha
Posted on: March 19, 2023

Job Description:

Were searching for a Coding Compliance Auditor, who works under the direction of the Billing Compliance Manager in conducting physician coding audits and providing related training. Handles special projects as assigned. Essential Functions

• Performs coding audits for physicians and advanced practice providers (APPs), such as nurse practitioners and physician assistants, under the direction of the Billing Compliance Manager
• Reviews documentation in Epic to determine if it supports the codes billed.
• Understands documentation requirements for Evaluation & Management (E/M) Services as well as surgical procedures
• Shares individual audit results with each provider with a focus on education and improvement opportunities
• Maintains current knowledge of CPT codes, HCPCS (Healthcare Common Procedure Coding System) codes, ICD-10 diagnosis codes, CMS regulations and payor-specific rules to facilitate the documentation, coding, billing and auditing processes.
• Researches and responds in a timely, accurate and professional manner to coding inquiries from physicians, APPs and other internal parties while ensuring the response is consistent with CMS regulations and other relevant payor guidelines
• Maintains a working knowledge of provider documentation and charging processes. Works collaboratively with coders throughout the organization, including those in the CBO, and HIM. KNOWLEDGE, SKILLS AND ABILITIES
  • Knowledge of medical terminology, anatomy and physiology
  • Knowledge of CPT, HCPCS and ICD-10 coding
  • Familiarity with coding-related reference materials, such as CPT Assistant, Coders Desk Reference, Coding Clinic, etc
  • Detail-oriented
  • Appropriate levels of confidence and composure useful in sharing audit results with physicians and APPs
  • Ability to work independently to effectively and efficiently perform assigned tasks
  • Ability to type 40 words per minute with 99% accuracy (with spell check) EDUCATION AND EXPERIENCE
    • High School Diploma or G.E.D. required
    • Minimum 2 years experience in a medical environment, such as a hospital, physician office or insurance company. CERTIFICATIONS/LICENSURE REQUIREMENTS
      • CPC (Certified Professional Coder), CCS (Certified Coding Specialist), CCS-P (Certified Coding Specialist- Physician-based) or CPC-A (Certified Professional Coder Apprentice) certification required EOE/Vets/Disabled Make a meaningful difference improving the lives of children! At Childrens, the regions only full-service pediatric healthcare center, our people make us the very best for kids. Come cultivate your passion, purpose and professional development in an environment of excellence and inclusion, where team members are supported and deeply valued. Opportunities for career growth abound as we grow our services and spaces, including the cutting-edge Hubbard Center for Children. Join our highly engaged, caring teamand join us in providing brighter, healthier tomorrows for the children we serve.

Keywords: Children's Hospital & Medical Center - Omaha, Omaha , Coding Compliance Auditor, Accounting, Auditing , Omaha, Nebraska