Advocate Aurora Health
Physician Coding Review Specialist - REMOTE
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Job Description
- Req#: R131088
- Responsible for completing all certified coder quality reviews. Working in collaboration with coding leads and supervisors.
- Develops and maintains monitoring tools for the evaluation of coding quality standards. Provides training and support in utilizing coding quality tools.
- Develops and maintains coding quality standardized reporting mechanisms. Provides standardized statistical reports of coding quality information to Professional Coding leadership and other appropriate parties.
- Identifies and trends coding quality issues/concerns. Recommends coding accuracy improvement strategies, including continued education and/or training plans. Provides feedback regarding coding guidelines, coding protocols/procedures and system edits to continually improve coding processes and ultimately the overall coding quality program.
- Conducts scheduled and ad hoc coding quality reviews. Provides results to Physician Coding leadership and education recommendations as needed. Conducts regularly scheduled reviews of encounters where coding has been changed or deleted by Coding team members to ensure accuracy and provide education recommendations.
- Reviews abstracted and coded encounters for coding accuracy and completeness. Provides feedback on billing system edits as applicable. Maintains up-to-date knowledge of Medicare, Medicaid and other regulatory requirements pertaining to nationally accepted coding policies and standards.
- Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA), or
- Coding Specialist - Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA), or
- Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), or
- Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA), or
- Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC), or
- Specialty Coding Professional (SCP) certification issued by the Board of Medical Specialty Coding and Compliance (BMSC), and
- Specialty Medical Coding Certification issued by the American Academy of Professional Coders (AAPC).
- Advanced training beyond High School that includes the completion of an accredited or approved program in Medical Coding Specialist.
- Typically requires 5 years of experience in expert-level professional coding experience and at least 3 years of experience in education/training of licensed clinicians.
- Advanced knowledge of ICD-10-CM, CPT and HCPCS coding guidelines.
- Advanced knowledge of medical terminology, anatomy and physiology.
- Advanced ability to identify coding quality issues/concerns and provide recommendations for improvement.
- Advanced ability to analyze trends and data and display in a statistical reporting format.
- Advanced analytical skills, with a high attention to detail.
- Intermediate computer skills including experience in using Microsoft Office or similar products and email.
- Advanced organization and communication (verbal and written) skills.
- Advanced ability to effectively train others through oral and/or written methods.
- Ability to work independently and exercise independent judgment and decision making.
- Ability to meet deadlines while working in a fast-paced environment.
- Ability to take initiative and work collaboratively with others.
- E/M experience desired
- Exposed to normal office environment.
- Position requires travel which will result in exposure to road and weather hazards.
- Operates all equipment necessary to perform the job.
10417 Revenue Cycle - Coding & HIM Support ProfessionalDepartment:
Full timeStatus:
YesBenefits Eligible:
40Hou rs Per Week:
Schedule Details/Additional Information:
First Shift full time
This is a REMOTE Opportunity
Major Responsibilities:
Licensure, Registration, and/or Certification Required:
Education Required:
Experience Required:
Knowledge, Skills & Abilities Required:
Physical Requirements and Working Conditions:
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
About the company
Advocate Aurora Health is a non-profit health care system with dual headquarters located in Milwaukee, Wisconsin