Physician Coding Auditor

Physician Coding Auditor

Ensemble 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:

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement
• This position pays between $57,400 to $99,000 annually based on experience

The Physician Coding Auditor 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 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 subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards. Ability to code and a clear understanding of the coding principles and guidelines for various specialties including Neurosurgery, Intervention Radiology, ENT, General Surgery, Cardiology, Anesthesia, Emergency Department.

Job Responsibilities:

• Quality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at HIM facility coding for both inpatient and outpatient accounts. Performs annual performance, randomized and quality assurance reviews to assess comprehension of training efforts. Also assists in CHAN and other external audits.
• Educating - Assesses the educational needs of coding staff and providers that are contracted/employed and outlined in the client SOW (included Provider Education verbiage) 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.
• Coordinating - Coordinates the presentation of ongoing professional seminars and materials via audio-conferences, webinars, and other publications. Maintains education records on all staff to include attendance records for all coding related educational activities.
• 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 auditing experience.
• 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.
• Position may require 20-40% travel to client sites.
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.
• This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.

Minimum Education:

• Associates Degree or Equivalent Experience

Required Certifications:

• CPC (Certified Professional Coder)
• CCS-P (Certified Coding Specialist-Phys Based)
• CCS (Certified Coding Specialist)
• CMPA (Certified Professional Medical Auditor)
• RHIA (Registered Health Information Administrator)
• RHIT (Registered Health Information Technician)

Join an award-winning company

Five-time winner of "Best in KLAS" 2020-2022, 2024-2025

Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024

22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024

Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024

Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023

Energage Top Workplaces USA 2022-2024

Fortune Media Best Workplaces in Healthcare 2024

Monster Top Workplace for Remote Work 2024

Great Place to Work certified 2023-2024

Innovation

Work-Life Flexibility

Leadership

Purpose + Values

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:

• Associate Benefits We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
• Our Culture Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
• Growth We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• Recognition We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories.

Ensemble 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 View email address on click.appcast.io.

This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role's range.