Acute Inpatient Coding Auditor

Ensemble Health Partners Salem, Ohio
acute health medical revenue revenue cycle cycle healthcare billing confidentiality medical coding procedures management people
January 23, 2023
Ensemble Health Partners
Salem, Ohio
Thank you for considering a career at Ensemble Health Partners!Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups.
They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.Ensemble keeps communities healthy by keeping hospitals healthy.
We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful.
This is why our people are the most important part of who we are.
By empowering them to challenge the status quo, we know they will be the difference.The Opportunity:
THE CAREER POTENTIAL There is no limit to the experiences, opportunities, and new directions you will have access to here at Ensemble Health Partners.
More importantly, you will be driving the surge in a whole new direction in healthcare.
That's something we can all take pride in as we take this journey together.
Ensemble Health Partners are a leading innovator in revenue cycle management and have been awarded the 2022 "Best in KLAS" designation for full revenue cycle outsourcing for the third year in a row, receiving the highest score in Ensemble's history.
This designation recognizes that out of all the companies reviewed that offer full revenue cycle outsourcing, Ensemble was ranked number one by healthcare leaders around the country for its excellence in improving financial outcomes and patient experiences THE OPPORTUNITY The Coding Auditor - DRG Validationwill perform coding quality audits of inpatient records to assure appropriateness and accurate procedure, diagnosis, and modifier assignment in accordance with ICD10 CM, CPT, Coding Clinic, Center of Medicare and Medicaid (CMS) guidelines, and National Correct Coding Initiatives (NCCI).
Essential Job Objectives:
Performs documentation and coding audits of emergency department (both charging/coding), outpatient ancillary services, recurring services, same-day surgery, and observation services for clients in identifying coding opportunities, compliance issues, educational opportunities, and to optimize reimbursement by ensuring that the diagnostic, procedural codes, and supporting documentation accurately reflect/support the service rendered and comply with ethical coding standards/guidelines and regulatory requirements.Integrates medical chart coding principles and objectivity in performance of medical audit activities.Draws on ICD-10-CM & PCS, CPT, HPCS, and CMS coding expertise and industry knowledge to substantiate conclusions.Performs work independently, reviews and interprets medical records and applies in-depth knowledge of coding principles to determine potential billing/coding issues, and quality concerns.Demonstrates elevated level of expertise in researching requirements necessary to make recommendations on client executive summary reports.
Assist in the development and coordination of executive report summary development and educational/training programs regarding elements of coding such as appropriate documentation, accurate coding, coding trends found during chart reviews.Maintains production goals and quality standards.
Audits against the expected level of quality and quantity.Requires the ability to ensure the confidentiality and rights of patients, the confidentiality of the client health system and patient documents required.Responsible for maintaining current certification, CEU's, and up to date knowledge of coding guidelines and how they relate to all outpatient services rendered in the acute care setting.
Requires the ability to ensure the confidentiality and rights of patients, the confidentiality of the client health system and patient documents required.Attends coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations.Experience We Love:
At least three (3) years of experience as a Coding Auditor.Knowledge of auditing concepts and principles.Advanced knowledge of medical coding and billing systems and regulatory requirements.Ability to use independent judgement and to manage and impart confidential information.Effective communication and interpersonal skills.Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation.Knowledge of current and developing issues and trends in medical coding procedures requirements.Ability to clearly communicate medical information to professional practitioners and/or the general public.Detailed knowledge of medical coding systems, procedures, and documentation requirements.Ability to adapt and modify medical billing procedures, protocol, and data management systems to meet specific operating requirements.Ability to provide guidance and training to professional and technical staff in area of expertise.Education/Certification:
HS Diploma or GED required, or associate degree/Bachelor's Degree preferred.Coding certification required:
(i.e.
RHIA, RHIT, CCS, CPC, COC, CIC)The #EnsembleDifference speaks for itself:
Three-time winner of "Best in Klas" 2020-2022Top Workplace USA Award (Nationally 2022)Top Workplace Innovation Award (Nationally 2022)Top Workplace Work-Life Flexibility Award (Nationally 2022)Top Workplace Leadership Award (Nationally 2022)Top Workplace Purpose and Values Award (Nationally 2022)Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive.
A few of those include:
Competitive compensation and benefits packages that reflect our commitment to providing fair and just workplaces.Wellness programming is designed to help our associates enhance their health, including a comprehensive annual health risk assessment.A culture truly participatory and to strengthen diversity and inclusion.Growth - Once you've joined our team, you will discover a variety of traditional and online learning opportunities, including tuition reimbursement, to help you acquire new skills and obtain degrees, certifications and CEUs.
And our managers will coach you toward greater success.Recognition - We recognize our associates through programs that include service awards, celebrations, and personal appreciation.
We also survey associates annually to assess their satisfaction with our organization and managers, and to identify areas for improvement.Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law.
If you require accommodation in the application process, please contact our Human Resources Department at 877-#-# or .
@ensemblehp.com.
This department will make sure you get connected to a Human Resources representative that can assist you.
EEO is the Law FMLA Rights - English La FMLA Espa ol Join an award-winning companyThree-time winner of "Best in KLAS" 2020-#2 Top Workplaces Healthcare Industry Award2022 Top Workplaces USA Award2022 Top Workplaces Culture Excellence AwardsInnovationWork-Life FlexibilityLeadershipPurpose + ValuesBottom line, we believe in empowering people and giving them the tools and resources needed to thrive.
Benefit packages - We offer a variety of medical plans, retirement options, and 401k options.Wellness Programs - Are designed to help our associates enhance their health, including a comprehen.

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