What are the responsibilities and job description for the PRN Coding Auditor position at University Clinical Health?
Job Type: PRN
Who We Are:
As the only independent and physician-led faculty practice plan of the University of Tennessee Health Science Center, University Clinical Health (UCH) offers best-in-class clinical care through a network of 175 providers across 19 specialties to meet the healthcare needs of the Mid-South community. UCH is a not-for-profit, non-tax-supported group practice and is here to serve the community while providing medical excellence to our patients.
Position Summary:
The Coding Compliance Auditor is responsible for performing consistent medical records audits to ensure compliance with the organization's coding procedures and standards to comply with state and federal laws governing reimbursement for health care services. In addition, the Coding Compliance Auditor/Physician Educator will provide coding and compliance training to physicians, clinical personnel, and billing staff to ensure accurate and ethical coding claims.
Key Results Areas (KRAs):
- Extracts relevant data from medical records and accurately reviews codes based on documentation
- Corrects extrapolation of official coding and select billing guidelines to specific coding situations
- Develops working relationships with UCH physicians and coders and performs effective physician and coder education regularly to ensure compliance with current coding requirements
- Detects physician and coder deficiencies to ensure proper communication and training
- Upholds high level of knowledge of current coding guidelines and creates and disseminates materials and presentations to educate physicians and coders on upcoming changes to coding guidelines
- Identifies and evaluates areas of potential risk concerning coding practices of providers and coders
- Maintains regular communication regarding potential areas of risk with General Counsel and other key partners, including but not limited to physician leadership, Directors of Operations, Department Chairs and Division Heads, Revenue Services functions, and UCH clinic staff
Core Competencies
- Demonstrated competence in coding
- Solid understanding of compliance and regulatory guidelines
- Demonstrates high level of ICD10 and CPT coding skill and knowledge
- Effective interpersonal skills and professionalism
- Ability to set priorities, coordinate multiple tasks, organize data, and follow up
- Effective verbal and written communication
- Strong knowledge of medical terminology, anatomy, and physiology with the ability to apply knowledge to the coding process
- Proven high levels of initiative, innovation, and collaboration
- Ability to work and make decisions independently and escalate issues appropriately
- Flexible and able to adapt to changing demands
Education & Experience:
- Bachelor’s Degree preferred
- RHIA, CCS-P, CPMA, or CPC certification or equivalent required
- Minimum of 3 years coding experience including inpatient/outpatient and/or professional surgical coding required
- Minimum of 1-2 years billing audit experience required