TPR Pro Fee Coding Compliance Auditor (Remote based in US) - Other Staff

The Coding Compliance Auditor conducts risk-based coding audits of professional fee diagnosis and procedural assignments in accordance with the official coding guidelines, as supported by clinical documentation in health record.

Essential Duties and Responsibilities:

• Understands, interprets, and applies professional fee coding guidelines for coding audits. Audits include a complex review of the medical record to determine coding accuracy as well as compliance with other professional fee services such as teaching physician, incident-to and split/shared services.
• Creates clear and accurate audit findings and recommendations in written audit reports that will be used for advising and educating Coders, Auditors, Managers, and Directors throughout the organization.
• Identifies documentation that impact coding accuracy. Clearly communicates (verbally and in written reports or summaries) opportunities for documentation improvement related to coding issues.
• Stays current with AMA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM, CPT, and HCPCS coding. Completes online education courses and attends mandatory coding workshops and/or seminars (ICD-10-CM, HCPCS and CPT updates), as directed. Reviews AMA, CMS, and CPT quarterly coding update publications. Attends all internal conference calls for Quarterly Coding Updates.
• Others may be assigned.

Knowledge, Skills, Abilities:

• Ability to consistently and accurately audit complex coding of professional fee services
• Ability to create clear and concise audit reports
• Expert level knowledge of medical terminology, ICD-10-CM/PCS and CPT coding guidelines and methodologies
• Must be detail oriented and with the ability to work independently and in team setting
• Computer knowledge of MS Office
• Must display excellent written and verbal communication skills
• Ability to demonstrate initiative and discipline in time management and assignment completion
• Ability to research difficult coding and documentation issues and follow through to resolution
• Ability to work in a virtual setting under minimal supervision

Education / Experience

• High school diploma/GED is required.
• Associates degree in relevant field preferred or combination of equivalent of education and experience.
• Three (3) years coding experience of professional fee services with experience in multiple specialties.
• One (1) year of experience in coding audit or quality review work.
• AAPC Coding Credential is required.

Compensation:

• Pay: $35.00 to $48.80 per hour. Compensation depends on location, qualifications, and experience.
• Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
• Observed holidays receive time and a half.

Benefits:

The following benefits are available, subject to employment status:

• Medical, dental, vision, disability, life, AD&D and business travel insurance
• Paid time off (vacation & sick leave)
• Discretionary 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance.
• For Colorado employees, paid leave in accordance with Colorado’s Healthy Families and Workplaces Act is available.

Tenet Healthcare complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.

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Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.