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 Outpatient Facility Coding Auditor integrates medical coding principles and objectivity in the performance of outpatient coding audit activities. Draws on ICD10CM, CPT and CMS coding expertise and industry knowledge to substantiate coding principles to determine potential billing/coding issues, and quality concerns. Under indirect supervision, the Coding Auditor will audit the quality of all outpatient work types to assure appropriateness and accuracy of Diagnoses, CPT, HCPCS, CCI edits, modifier assignment in accordance with ICD10 CM, CPT, HCPCS, CPT Assistant, Coding Clinic, Center of Medicare and Medicaid (CMS) guidelines, and National Correct Coding Initiatives (NCCI).
Job Responsibilities:
The audit professional integrates medical coding principles and objectivity in the performance of coding audit activities. Draws on ICD10CM, HCPCS, NCCI, and CMS coding expertise and industry knowledge to substantiate coding principles to determine potential billing/coding issues, and quality concerns
Participates in client system education to gain the knowledge necessary to audit client accounts in ensuring that the coding is supported by the patient's clinical documentation, coding/cdi guidelines and other regulatory standards/guidelines as appropriate
Maintain meticulous documentation, spreadsheets, account, and claim examples of root cause issues. Performs searches of governmental, payor-specific, hospital-specific, regulatory body, and literature rules, regulations, guidelines to identify and coding and billing requirements to make recommendations to client
Assist in the development and coordination of the executive summary reports, education and training client coding companion as it relates to the outcomes of the coding audit
Meet established productivity standards for coding audits & coding certification requirement
Attends coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations
Provides excellent customer service, in an organized and efficient manner, while maintaining a positive attitude
Experience We Love:
3+ years of outpatient facility coding experience
3+ years of auditing experience
Advanced knowledge of medical coding and billing systems, documentation, and regulatory requirements
Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation
Knowledge of current and developing issues and trends in medical coding procedures requirements
Ability to clearly communicate medical information to professional practitioners and/or the general public
Ability to adapt and modify medical billing procedures, protocol, and data management systems to meet specific operating requirements
Ability to provide guidance and training to professional and technical staff in area of expertise
Competent with the use of all Microsoft Office applications, including Word, Excel, and Power Point.
Minimum Education:
High School Diploma or GED
Required Certifications:
Candidate must have and keep current at least one of the following professional certifications (CCS Preferred):
CPC (Certified Professional Coder)
CCS (Certified Coding Specialist)
RHIA (Registered Health Information Administrator)
RHIT (Registered Health Information Technician)
#LI-HB1
#LI-REMOTE
Join an award-winning company
Three-time winner of “Best in KLAS” 2020-2022
2022 Top Workplaces Healthcare Industry Award
2022 Top Workplaces USA Award
2022 Top Workplaces Culture Excellence Awards
Innovation
Work-Life Flexibility
Leadership
Purpose + Values
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact TA@ensemblehp.com.
This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.