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Coding Auditor

**Location:** Larkin Bldg @ Exchange Street

**Location of Job** : US:NY:Buffalo

**Work Type** : Full-Time

Shift 1

Job Description

The Physician Coding Auditor is a member of the Internal Audit and Corporate Compliance Department. Responsible for audits to determine organizational integrity of billing for physician and clinical fees, including detection and correction of documentation, coding and billing errors and/or medical necessity of services billed. Audits consist of evaluation of the adequacy and accuracy of documentation in support of services billed, including E/M and other third party payor codes, medical necessity of services, reimbursement overpayments and underpayments, and compliance with other documentation, coding and billing standards. Will apply standardized audit scoring methodology to consistently evaluate documentation and coding, and standardized audit findings methodology to report audit results. With guidance from Director of Audit, communicates audit results to physician departments and departmental leadership, HIM leadership, senior hospital management, coders, billers and other appropriate staff. Provides coder education and makes recommendations for management corrective action. Researches regulatory requirements for physician coding and billing and provides support to Director of Audit in providing advice to stakeholders. Assists Director of Audit in responding to questions and formal inquiries from both internal stakeholders and outside regulatory agencies. Works with Director of Audit to process required re-billing and self-disclosures to payors.

Education And Credentials

Associates degree is required, preferably in Health Information Technology or Medical Record Technology. Preferred certifications/licensure: (CPC-CEMC) Certified Professional Coder- Certified Evaluation & Management Coder. (RHIT) Reg Health Info Tech. (CDEO) Certified Documentation Expert Outpatient. (RHIA) Reg Health Info Admin.

Experience

Requires 2 years of experience in analytical thinking, problem solving, verbal and written communication; team player in a professional environment; Microsoft Office(Excel, Word) and Internet. Requires 2 years of experience in Health Information/Coding in a clinic or ambulatory surgery setting; ICD-10 and CPT-4 coding. Requires 2 years of experience in Federal, state, and private payer regulations.

Working Conditions

Essential:

* Weight Requirement - Sedentary (10 lbs)

Job Details

Department: KH Internal Audit and Compliance

Standard Hours Bi-Weekly: 75.00

Weekend/Holiday Requirement: No

On Call Required: No

**With Rotation:** No

**Scheduled Work Hours:** 8a-4p

Work Arrangement: Hybrid

Union Code: N00 - Non Union KH

Requisition ID#: 9162

Grade: HR211

Pay Frequency: Bi-Weekly

**Salary Range:** $28.79 -$39.59

*Wage will be determined based on factors such as candidate's experience, qualifications, internal equity, and any applicable collective bargaining agreement.

_Kaleida Health’s mission is to advance the health of our community, and we believe our diversity, equity, and inclusion (DEI) strategic work is mission- critical for the good of our workforce and the community who need and depend on our care and services. We understand that racism and health inequities stand firmly in the way of advancing the health of our community, and Kaleida Health envisions DEI as the pursuit of equity and restorative justice for every person. We will exemplify courage and accountability through both the professing and practice of our core values for our friends, colleagues, and community. Kaleida Health is committed to creating a culture of equity and inclusion where diversity is valued and celebrated!_

**Position** Coding Auditor

**Location** US:NY:Buffalo | Health Information | Full-Time

**Req ID** null

Equal Opportunity Employer

Kaleida Health is committed to diversity and believes our workforce is strengthened by the inclusion of and respect for our differences.

Kaleida Health is an equal opportunity and affirmative action employer. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, religion, sex, national origin, citizenship status, creed, gender, gender identity or expression, sexual orientation, disability, veteran status or any other factor which cannot lawfully be used as a basis for an employment decision.

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for or perform your job.