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Job Summary

• Why This Role Matters

As a Coding Audit Response Specialist, you will have the ability to be an educational resource to a dynamic team of coders, while supporting patient care by driving accuracy and adherence to coding guidelines, governmental and private Third-Party rules, and regulations.

What You’ll Do

+ Respond to external and internal audits for outpatient services that include an assessment of ICD-10- CM/PCS, CPT or HCPCS codes and the accuracy of assignment for Novant Health Facilities as assigned by Corporate Coding Audit Response Lead.

+ Audits will include but will not be limited to coding audits, charge edit and denial audits, commercial payers, and CMS payers. Responses will be coordinated through the Audit Response Lead for all the applicable Novant Health facilities.

+ Support the Corporate Coding Audit Response Lead/Coding Supervisor by proactively managing significant issues in coding and charging (including communications and escalation pathways), problems preventing payment of claims, issues in coding including barriers and successes, accurate and timely processing of account details, denials, and be able to capture and communicate information.

+ Collaborate with multi-disciplinary teams to address issues related to coding, charging, clinical documentation improvement operations, accuracy and timeliness, unbilled claims management, claim edits and denial management.

+ Overtime may be required as dictated by organizational business needs.

What You’ll Need

Required:

+ CCS, CCS-P, CPC, CPC-H, CIRCC, CCA, COC, CIC, RHIT, or RHIA licensure.

+ High School Diploma or GED.

+ 3+ years of experience coding in acute care facility or professional coding.

+ Extensive knowledge of ICD-10-CM/PCS and CPT coding principles and guidelines.

+ Advance level knowledge of Medical Terminology, Anatomy and Physiology.

+ Excellent analytical, written & oral communication skills and strong attention to detail.

+ Able to prioritze workload, meet deadlines and work during times of unusually high volume as workload demands.

+ Must be able to troubleshoot via phone with Lead, Supervisor, or IT.

+ Knowledge of Encoder Software.

Preferred:

+ Associate Degree.

+ Strong outpatient surgery, Interventional Radiology, and Injection & Infusion coding experience.

+ 1+ year of experience auditing for DRG assignment or CPT/APC assignment and diagnosis coding accuracy.

+ Extensive knowledge of EPIC and 3M Encoder software.

+ Ability to navigate CMS website for NCCI policy/tables, NCD/LCD information, and Medicare Claims Processing Manual.

+ Extensive knowledge of charging (HCPCS) and CPT coding.

+ Experience working remotely.

+ Experience working in Microsoft Office to include Outlook, Teams, and Excel and Zoom Video Conferencing.

+ Pharmacology Clinical Documentation Improvement skills.

+ Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing and the ability to apply this knowledge.

+ What’s In It for You

+ The opportunity to work remotely if you reside in: FL, GA, IN, LA, MS, NV, NC, OK, SC, VA, WY

+ A flexible work schedule following initial on the job training.

+ Comprehensive benefits include health, dental, vision, and life insurance.

+ Retirement fund with matching contributions.

+ Tuition assistance for qualifying team members.

+ Employee assistance programs and discounts.

Job Opening ID

95319