Senior Coding Quality Auditor

Senior Coding Quality Auditor

Hourly Pay Range: $26.61 - $39.92 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.

Position Highlights:

• Location: Warrenville, IL/Hybrid
• Full Time/Part Time: Full-Time (40 hours per week)
• Hours: Monday-Friday, 8:00am-4:30pm
• Required Travel: travel on-site and to other Endeavor locations will be required

What You Will Do:

• Conducts retrospective audits to ensure compliance with internal policies and procedures and existing CMS regulations; identifies and recommends opportunities for process improvements so that productivity and quality goals can be met or exceeded and operational efficiency and financial accuracy is achieved.
• Effectively communicates the audit process and results to the appropriate departments and management.
• Educates leaders and staff when deficiencies in documentation and code selected are identified
• Develops timelines for auditing and manages auditing according to schedule.
• Reviews charge information, claim forms, and insurance correspondence to determine if coding, billing, claim follow-up, payment receipts, posting activities, and credit processing is being performed in an accurate and timely manner and is supported by documentation.
• For all assigned records assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards. Remains current on ICD-10 codes, CMS documentation requirements, and State and Federal regulations.
• Coordinates with Manager and Corporate Compliance Department on any compliance investigations that involve physician groups.
• Participates in compliance investigations, as needed
• Attends Internal and External education programs/conferences in order to support continuous improvement, career growth and development. Encourages professional membership in the American Academy of Professional Coders (AAPC) or American Health Information Management (AHIMA).

What You Will Need:

• Education: High School Diploma
• Certification: CPC or CCS-P required
• Experience: 3+ years coding and auditing experience. 5+ years experience working in a hospital or clinical setting
• Unique or Preferred Skills:
• Strong analytical, problem solving, interpersonal, verbal/written communication, organizational and team development skills are necessary.
• Knowledge of Microsoft Office Suite - Proficient in PC skills including Microsoft Excel, Power Point and Word.
• Ability to interact with all levels of health care team professionally.
• Ability to write correspondence proficiently and to communicate in a professional manner and effectively handles difficult situations and/or individuals objectively.

Benefits (For full time or part time positions):

• Opportunity for annual increases based on performance
• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, Pet and Vision options
• Tuition Reimbursement
• Free Parking
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) all recognized as Magnet hospitals for nursing excellence.

When you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.

Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

At Endeavor Health, we are united by a shared commitment to working together to create a culture of connection and belongingeach of us bringing different skills and experiences as we deliver safe, seamless, and personal care. Every person, every time. We are committed to fostering an environment where all team members can be their best, learn, and pursue excellence together.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.