Job Summary

The Coding Audit Response Specialist position responds to external and internal audits that include an assessment of ICD-10- CM/PCS, CPT or HCPCS codes and the accuracy of assignment for Novant Health Facilities as assigned by Corporate Coding Audit Response Lead. Audits will include but will not be limited to: coding audits, charge edit and denial audits, commercial payers, and CMS payers. Responses will be coordinated through the Audit Response Lead for all applicable Novant Health facilities. The Coding Audit Response Specialist will support the Corporate Coding Audit Response Lead/Coding Supervisor by proactively managing significant issues in coding and charging (including communications and escalation pathways). The Corporate Coding Audit Response Specialist will collaborate closely with other members of the Corporate Coding Team in addressing issues related to code assignment accuracy and timeliness, appropriate provider documentation, unbilled claims management, claim edits and denial management. This position will often collaborate with multi-disciplinary teams in addressing issues related to coding, charging, and clinical documentation improvement operations. The Coding Audit Response Specialist will support the Corporate Coding Audit Response Lead/Supervisor by identifying (including communications) problems preventing payment of claims, issues in coding including barriers and successes, accurate and timely processing of account details, denials, and be able to capture and communicate information. The Corporate Coding Audit Response Specialist will be involved in strategic initiatives and projects to improve processes and workflows. This is a fully remote position, however at times, video conferencing and attendance onsite may be required as directed by Corporate Coding Leadership.

Come join a remarkable team where quality care meets quality service, in every dimension, every time. Let Novant Health be the destination for your professional growth.

At Novant Health, one of our core values is diversity and inclusion. By engaging the strengths and talents of each team member, we ensure a strong organization capable of providing remarkable healthcare to our patients, families and communities. Therefore, we invite applicants from all group dynamics to apply to our exciting career opportunities.

Responsibilities

It is the responsibility of every Novant Health team member to deliver the most remarkable patient experience in every dimension, every time.

• Our team members are part of an environment that fosters team work, team member engagement and community involvement.
• The successful team member has a commitment to leveraging diversity and inclusion in support of quality care.
• All Novant Health team members are responsible for fostering a safe patient environment driven by the principles of "First Do No Harm".

Qualifications

• Education: High School or GED, required. 2 Year / Associate Degree, preferred. 4 Year / Bachelors’ Degree, preferred.
• Experience: Minimum of three (3) years’ experience in coding in acute care facility or professional coding, required.
  • Minimum of three (3) years outpatient surgery coding experience, preferred.
  • Minimum of one (1) year experience auditing for DRG assignment or CPT/APC assignment and diagnosis coding accuracy, preferred.
• Licensure/Certification: CCS, CCS-P, CPC, CPC-H, CIRCC, CCA, COC, CIC, required. RHIA, RHIT, preferred.
• Additional Skills (required):

  • Extensive knowledge of ICD-10-CM/PCS and CPT coding principles and guidelines.

  • Excellent written and oral communication skills.

  • Excellent analytical skills.

  • Must be detail- oriented and analytical in nature.

  • Medical Terminology, advanced level.

  • Anatomy and Physiology, advanced level.

  • Must be able to work during times of unusually high volume and of unusual need as workload demands.

  • Must be able to prioritize workload and meet assigned deadlines.

  • Must be able to troubleshoot via phone with Lead, Supervisor, or IT.

  • Promotes good morale and cooperation.

  • Encourages others and values their input.

  • Anticipates and responds positively to changing skills requirements.

  • Knowledge of Encoder Software.

  • Certifications must be kept up to date.

• Additional Skills (preferred):

  • Computer skills in databases and data entry experience.

  • Extensive Knowledge 3M Encoder software.

  • Extensive knowledge of Epic.

  • Ability to navigate CMS website for NCCI policy/tables.

  • Ability to navigate NCD/LCD information, and Medicare Claims Processing Manual.

  • Extensive knowledge of charging (HCPCS) and CPT coding.

  • Experience working in remote environment.

  • Experience working in Microsoft Office to include Outlook, Teams, and Excel.

  • Experience working in Zoom Video Conferencing.

  • Pharmacology Clinical Documentation Improvement skills.

  • Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing and the ability to apply this knowledge.

Job Opening ID

81692

• Education: High School or GED, required. 2 Year / Associate Degree, preferred. 4 Year / Bachelors’ Degree, preferred.
• Experience: Minimum of three (3) years’ experience in coding in acute care facility or professional coding, required.
  • Minimum of three (3) years outpatient surgery coding experience, preferred.
  • Minimum of one (1) year experience auditing for DRG assignment or CPT/APC assignment and diagnosis coding accuracy, preferred.
• Licensure/Certification: CCS, CCS-P, CPC, CPC-H, CIRCC, CCA, COC, CIC, required. RHIA, RHIT, preferred.
• Additional Skills (required):

  • Extensive knowledge of ICD-10-CM/PCS and CPT coding principles and guidelines.

  • Excellent written and oral communication skills.

  • Excellent analytical skills.

  • Must be detail- oriented and analytical in nature.

  • Medical Terminology, advanced level.

  • Anatomy and Physiology, advanced level.

  • Must be able to work during times of unusually high volume and of unusual need as workload demands.

  • Must be able to prioritize workload and meet assigned deadlines.

  • Must be able to troubleshoot via phone with Lead, Supervisor, or IT.

  • Promotes good morale and cooperation.

  • Encourages others and values their input.

  • Anticipates and responds positively to changing skills requirements.

  • Knowledge of Encoder Software.

  • Certifications must be kept up to date.

• Additional Skills (preferred):

  • Computer skills in databases and data entry experience.

  • Extensive Knowledge 3M Encoder software.

  • Extensive knowledge of Epic.

  • Ability to navigate CMS website for NCCI policy/tables.

  • Ability to navigate NCD/LCD information, and Medicare Claims Processing Manual.

  • Extensive knowledge of charging (HCPCS) and CPT coding.

  • Experience working in remote environment.

  • Experience working in Microsoft Office to include Outlook, Teams, and Excel.

  • Experience working in Zoom Video Conferencing.

  • Pharmacology Clinical Documentation Improvement skills.

  • Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing and the ability to apply this knowledge.

It is the responsibility of every Novant Health team member to deliver the most remarkable patient experience in every dimension, every time.

• Our team members are part of an environment that fosters team work, team member engagement and community involvement.
• The successful team member has a commitment to leveraging diversity and inclusion in support of quality care.
• All Novant Health team members are responsible for fostering a safe patient environment driven by the principles of "First Do No Harm".