Coding Educator and Auditor (Full-Time)

Coding Auditor And Educator (Remote)

Employment Type: Full-Time

Shift: Days

Additional benefits: tuition reimbursement, free parking, employee discounts

Quality of life: flexible work schedules

Monday-Friday

The Professional Coding Auditor Educator performs medical record audits including but not limited to analysis of medical record documentation, validation of primary and secondary diagnoses and procedures; and ensuring proper assignment of diagnosis and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS).

Monitors accuracy of centralized coders' charge capture and coding with proper ICD-10, CPTs, as well as proper modifiers, adhering to local ministry and Trinity practices and policies.

Partners with leadership to improve HCC, high risk scoring, with provider and coder education.

Conducts ongoing reviews of patient medical record documentation and procedural and diagnosis coding by each practitioner.

Responsible for practitioner education in areas related to coding, documentation, and compliance.

Works closely with leadership and the department to establish and modify the charge description master (CDM) methodology and pricing models to ensure accuracy and regulatory compliance.

Reports to the Manager, Provider Revenue Operations

High school diploma or equivalent combination of education and experience

• Minimum of 2-5 years of professional coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCs modifiers. Knowledge of Medicare, Medicaid, and other third-party billing rules and regulations.
• 3-6 years of professional coding experience; prior auditing experience (Preferred)
• Ability to work collaboratively in a team-oriented environment with a strong customer-service orientation.
• Ability to handle patient and organizational information in a confidential manner.
• Ability to demonstrate competency with a standard desktop and Windows-based computer system, including a basic understanding of email, e-learning, intranet and computer navigation. Ability to use other software as required to perform the essential functions of the job.
• Solid understanding of ICD-10 and CPT coding and medical terminology, with knowledge of Medicare, Medicaid, Health Maintenance Organization and commercial insurance plans.
• Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. Holy Cross Health is a Catholic, not-for-profit health system that serves more than 240,000 individuals each year from Maryland's two largest counties Montgomery and Prince George's counties. Holy Cross Health earns numerous national awards, clinical designations and accreditations across a wide range of specialties for providing innovative, high-quality health care services. Holy Cross Health is an Equal Employment Opportunity (EEO) employer. Qualified applicants are considered for employment without regard to Minority/Females/disabled/Veteran (M/F/D/V) status.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Trinity Health