Coding Auditor & Educator

Summary

Assists with the coding and documentation auditing function of Corporate Compliance. At the recommendation of the Director—Compliance Audits and Training, acts as an in-house consultant for physicians and other Mercy Health Services staff on issues related to documentation, coding, billing, and the federal and state rules and regulations that govern them. Presents appropriate documentation and coding training to physicians and other staff involved in the billing process.

Responsibilities

• Develop department auditing policy to achieve business strategies by enhancing our effectiveness and performance- goal less than 5% error rate.
• Ensure the providers documentation and code selection are appropriate and to the highest specificity.
• Monitor and report progress of coders during probation period - six month.
• Stay up to date on coding changes and review changes with coding department.
• Analyze reports to identify coding trends and make recommendations to align education materials with those trends.
• Develop content and material for the education of coders monthly.
• Under manager, Coding Auditor will be responsible for maintaining completeness of medical record documentation and coding accuracy by conducting informal monthly audits per physician as well as per coder.
• Identify documentation issues both CPT and ICD10 develop processes for improvement.
• Collaborate with manager and Revenue Cycle department to create billing and documentation policies to help reduce denials, clarify conflicting or non-specific denials due to documentation.
  
  
  

Requirements

Education and Work Experience:

• Must possess a high school diploma or GED; Bachelor's Degree Preferred
• Candidate MUST currently be a certified coder (i.e., CPC, CPC-H, CCS, CCS-P) with at least three (3) years active coding experience.
• Auditing experience preferred.
• Excellent verbal and written communication skills.
  
  
  

Experience with MDaudit a plus.

• Knowledge, Skills and Abilities:
• Computer proficiency and technical aptitude with the ability to utilize one or more of the following:
• Microsoft Word, Power Point, Excel
• Microsoft Outlook
• Epic
• Performance Manager/NetLearning
• Must be able to read, write, and speak the English language in an understandable manner.
• Must be able to work independently and possess the ability to make independent decisions when circumstances warrant such action.
• Must possess the ability to effectively communicate and deal tactfully with other personnel, visitors, patients, physicians, customers, and the public.
• Must be flexible, have personal integrity, and the ability to function effectively as a team with other employees.
• Must be able to follow written and oral instructions.
• Ability to demonstrate in-depth knowledge of current coding classification systems, concepts, practices, compliance, and policies related to professional coding.

• Other Requirements:
• The demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
• Must possess a sight/hearing senses or use prosthetics that will enable those senses to function adequately so that the requirements of this position may be fully met.
• Must be able to stand, sit, walk, bend or lift intermittently throughout the work day.
• May need to work beyond normal working hours and in other positions temporarily when needed.
• May be required to physically walk throughout the institution and/or ancillary buildings to conduct the duties of the position.
• May be subjected to hostile and emotionally upset patients, visitors, customers, and employees.
• May be subjected to frequent interruptions.
• May work in either a well lighted or dimly lit; ventilated area.
• Potential exposure to respiratory conditions and/or materials. Requires wearing respirator protective equipment at times. Must be capable of performing duties while wearing respiratory protection and clothing.
• May be exposed to infectious diseases, radiation, extreme temperatures.
• May need to utilize personal protective equipment throughout the work period.
• Must be able to work in stressful situations, handle multiple assignments at the same time and complete as the deadline requires.
• tive equipment at times. Must be capable of performing duties while wearing respiratory protection and clothinMay be exposed to infectious disease

• etics that will enable those senses to function adequately so that the requirements of this position may be fully met..
  
  
  

Benefits

Benefits Eligibility is based on your scheduled FTE status and Job Category

• Competitive health, prescription, vision and dental benefits & wellness credit for eligible employees
• 403(b) retirement plan with generous company match and “catch up” provision
• Paid Time Off (PTO) & company paid holidays
• Tuition reimbursement
• Mental Health resources and other employee related wellness opportunities through our Employee Assistance Program
• Employer paid Short & Long Term Disability benefits for eligible employees
• Voluntary Benefits
• Discounts on auto & home insurance and Verizon plans
• Mercy’s Rewards & Recognition Program rewarding employees for going above and beyond in living Mercy’s Mission and Values
  
  
  

EEO Statement

Mercy Health Services is sponsored by the Sisters of Mercy. We are an Equal Opportunity Employer (EEO) recruiting talent for Mercy Health Services, which serves the greater Baltimore Metro and surrounding Maryland areas.