Physician Coding Auditor

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

The Opportunity:

CAREER OPPORTUNITY OFFERING:

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement

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 Neurosurgery, Intervention Radiology, ENT, General Surgery, Cardiology, Anesthesia, Emergency Department.

Job Responsibilities:

• Quality Review - Monitors and audits Professional Fee inpatient and outpatient accounts across all contracted clients. Performs annual performance, randomized and quality assurance reviews to assess comprehension of training efforts.
• Educating - Assesses the educational needs of coding staff and providers contracted/employed and outlined in the client SOW (included Provider Education verbiage) and develops programs or research educational resources to meet those needs. Creates and delivers presentations develops learning material, including recordings, PowerPoints, Pocket Cards, Quick Reference Guides, handbook and other educational materials
• Edits/Denials/Coding - Assists with edits, denials, and appeals. Assists with coding and working holds on an as needed basis
• Training - Assists with training providers, client leadership, in addition to, 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 audit findings reports to coding management, individual coders and leadership as needed/requested along with providers 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.