Facility Coding Auditor

  • Remote
  • Ensemble Health Partners
*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.

*This position is a work at home position. The Candidate must have:*
* *5 Years coding experience*
* *3+ years facility coding audit experience (such as DRG and APC Validation*

*Must also have Current Certification for at least one of the following, CCS preferred:*
* *CPC (Certified Professional Coder) *
* *CCS (Certified Coding Specialist) *
* *RHIA (Registered Health Information Administrator) *
* *RHIT (Registered Health Information Technician)*

Develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Facility Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a technical resource for all involved personnel; ensures that information is accurate and current, meeting facility coding standards.

*Job Responsibilities:*
* Quality Review - Monitors and audits inpatient and/or outpatient accounts across the system, looking at facility coding for inpatient and/or outpatient accounts. Performs annual performance, randomized and quality assurance reviews to assess comprehension of training efforts. Performs DRG Validation reviews, ensuring proper facility coding guidelines have been followed as well as reviewing for clinical support of the coded diagnoses. Also assists other external and regulatory audits.
* Educating - Assesses the educational needs of coding staff that are contracted/employed and outlined in the client SOW and develops programs or researches educational resources to meet those needs. Assists with Task Force, CDE and quality department related education. Creates presentations, develops learning material, handbook and other educational materials
* Edits/Denials/Coding - Assists with edits, denials and appeals. Also assists with coding and working holds on an as needed basis
* Training - Assists with training new and existing staff. Develops all training materials and coding aids for both formal training and use by coders in daily work. Identifies coders to be cross-trained and suggests areas for training improvement. Assists in the implementation and administration of effective systems, processes, and procedures
* Resource - Serves as a technical resource for all involved personnel; ensures that information is accurate and current, meeting professional coding standards. Performs miscellaneous job-related duties as assigned
* Reporting - Provides reports of audit findings to coding management, individual coders and leadership as needed/requested along with providers that are contracted/employed and outlined in the client SOW (Included Provider verbiage). Assists with the creation of various documents and reports as requested. Immediately provides reports related to compliance risks when requested

*Experience We Love:*
* 5+ years of coding experience.
* 3+ years of facility coding audit experience (such as DRG and APC Validation).
* Proficiency in multiple EMR’s, encoders, and the Microsoft Office suite.
* Educated in HIPAA regulations; must maintain strict confidentiality of patient and client information.
* Consistently achieves quality and productivity standards.
* Ability to organize and complete work in a timely manner.
* Ability to read, write and effectively communicate in English.
* Ability to understand medical/surgical terminology.
* Above average written and verbal communication skills.​

*Required Certifications:*

Candidates must have and keep current at least one of the following professional certifications (CCS Preferred):
* CPC (Certified Professional Coder)
* CCS (Certified Coding Specialist)
* RHIA (Registered Health Information Administrator)
* RHIT (Registered Health Information Technician)

*The Ensemble Difference speaks for itself:*
* Three-time winner of “Best in Klas” 2020-2022
* Top 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.

#INDHP

Job Type: Full-time

Benefits:
* 401(k)
* Dental insurance
* Employee discount
* Flexible spending account
* Health insurance
* Life insurance
* Paid time off
* Tuition reimbursement
* Vision insurance
Schedule:
* Day shift
* Monday to Friday



Experience:
* coding: 5 years (Required)
* coding auditing: 3 years (Required)
* Medical billing: 1 year (Preferred)

License/Certification:
* Current Certification: CPC, OR CCS, OR RHIA, OR RHIT (Required)


Work Location: Remote

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