We have an exciting opportunity to join our team as a Coding Auditor-Revenue Mgmt.
In this role, the Coding Auditor performs detailed audits of medical records to ensure accuracy of coding and charges for services provided. The role includes reporting audit outcomes and trends through written reports, working collaboratively with clinical, compliance, financial and hospital information management departments to improve documentation, coding, and charge processes. This position reports directly to the Revenue Management Initiatives Department.
Demonstrates knowledge of the organizations core values and incorporates them into the performance of duties.
Performs concurrent and retrospective audits of accounts to ensure correct coding. Utilizes correct coding initiative conventions and follows established policies and guidelines to determine accurate code selection based upon documentation in the medical record. Makes necessary coding corrections or facilitates corrections via communication with Hospital Information Management (HIM) department.
Identifies unbilled, under-billed and over-billed supplies and or services on accounts and makes necessary corrections.
Defends facility charging and coding practices during focused audits.
Follows up with clinical departments to understand services provided and procedures performed.
Identifies compliances risks and financial opportunities based on chart reviews.
Creates/updates and/or maintains charge protocol manuals for service areas with input from interdisciplinary team members.
Develops training material and conducts in-services related to coding topics.
Makes ongoing observations and recommendations to prevent future coding and charging issues, prepares reports as required by management regarding process improvement recommendations/initiatives and coding issues.
Participates in and/or leads inter-departmental process improvement initiatives.
Liaises with other hospital departments and serves as point of contact on coding topics.
Investigates and documents any potential for new program and product development.
Submits recommendations for updates in the Charge Description Master (CDM) and other systems (such as EPIC) based upon audit findings and coding guidelines.
Adheres to established productivity standards, maintains coding credentials, and participates in departmental performance improvement activities and work level.
Communicates and works with all internal and external customers.
Performs other duties as assigned.
To qualify you must have a 1. Associate or Bachelors Degree in health-related field, Accounting, or Finance. Active Coding Certification/Credentials with two (2) years of recent coding experience. Demonstrated proficiency in medical record analysis and ICD-10CM/CPT 4 coding methodology and guidelines. 2. Work experience with PCs, MS Office products (Outlook, Word, Excel, etc.) 3. EPIC experience preferred or familiarity with electronic medical record documentation. 4. Proficient in payment review systems, hospital information systems, clinical record information systems, and coding methodologies. 5. Strong quantitative, analytical, interpersonal and communication skills. 6. Understand medical records, hospital bills, insurance terms, payment methodologies and the charge master. 7. Knowledge of regulatory agencies requirements (CMS, Medicaid, & JCAHO) and remain current on new regulations, policies and procedures.
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision.
NYU Langone Health, a world-class patient-centered integrated academic medical center, is one of the nation's premier centers for excellence in clinical care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals – Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, one of only five hospitals in the nation dedicated to orthopaedics and rheumatology; and Hassenfeld Children's Hospital, a comprehensive pediatric hospital supporting a full array of children's health services across the medical center – plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The medical center's tri-fold mission to serve, teach, and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education and research. For more information, go to www.nyulangone.org.