Job Description

Employment Type:

Shift:

Description:

SPHP Coding Auditor and Educator – St. Peter’s Health Partners Medical Associates, P.C. - Fully Remote

Responsibilities                                                                                                         

• Conducts routine monitoring of key acute care risk areas such as medical record documentation, coding, billing, reimbursement, and privacy; providing follow up education
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• Conduct specialized audits for selected specialties and provide follow up education
• Prepare and present periodic coding education to providers and coders in specialized areas
• Provide input to the organization’s coding education program to include national and industry coding standards.
• Coordinates review, response, and corrective action(s) in response to incidents reported directly to the Compliance Department or through the Compliance Line on issues related to coding.
• Assists in performance of annual risk assessment in collaboration with Internal Audit, incorporating risk areas identified in the OIG and OMIG Work Plans
• Forms and leads work teams to develop and implement corrective action plans in response to audits/reviews

Key Relationships/Interactions

• Reports to Manager Compliance
• SPHPMA leadership, SPHP Compliance and Privacy, Trinity Compliance and Audit staff, Internal Audit, External Audit, employees, physicians, allied health professionals, and counsel.

Key Competencies

• Demonstrated knowledge in coding concepts, guidelines and regulations
• Demonstrated knowledge of government and commercial payer regulations
• Strong project management skills
• Attention to detail, objective, analytical, problem-solver
• Excellent interpersonal skills, ability to collaborate and build consensus
• Respects and maintains confidentiality
• Computer proficiency including experience using Word, Excel, PowerPoint, Teams and similar office programs; able to navigate electronic medical records and billing systems
• Able to work independently on complex issues, prioritize, multi-task and meet deadlines/goals
• Experience in medical/legal issues in a health care environment and/or medical terminology and coding

- Current Certification as a Professional Coding Specialist (CPC, CCS-P) or similar required.

- Minimum of 2 years of experience in medical coding, preferably in a cardiology setting.

- Knowledge of cardiology procedures and terminology highly preferred

- Advanced knowledge of ICD-10 and CPT coding guidelines and regulations.

- Ability to work independently and in a team environment.

- Strong analytical, problem-solving, and critical thinking skills.

- Excellent communication and interpersonal skills.

- High level of attention to detail and accuracy.

- Proficient in using electronic health record (EHR) and coding software.

Pay Range: $27.15-39.40

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. The pay range may also vary within the stated range based on location.

Our Commitment to Diversity and Inclusion
 

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.