Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
SCOPE OF ROLE
Centrum Health, a part of NeueHealth, a Bright Health Group company, is a leading primary care provider organization focusing on delivering industry-leading quality of care and affordability to the people we serve in Florida, Texas and North Carolina. We are looking for a Coding Auditor to provide support and education to a team of coders. Responsible for the QA Process and tracking coder accuracy. The Coding Auditor is to proactively also mentor a train new coders as they get hired.
The Coding Auditor job description is intended to point out major responsibilities within the role, but it is not limited to these items.
- Position oversees a team of Medical Coders and is responsible for ensuring compliance with regulatory requirements with coding & billing completeness and accuracy, and data integrity.
- Selects, trains, coaches, motivates, conducts performance evaluations, and directs the workflow for staff assigned to the coding auditor
- Monitoring of the coding accuracy scorecard which includes open encounters; validation reviews, coding accuracy; staff stats; etc. Participates in the improvement of processes and programs
- Works collaboratively with Coding Manager and Risk Adjustment Director to establish coding quality, productivity and best practices. Monitors goals and benchmarks productivity and quality standards in conjunction with industry trends. Identifies potential improvements and moves team to achieve next level of performance with regards to coding quality, productivity and best practices.
- Participates in developing standard coding policies/procedures/guidelines to ensure compliance with federal, state and local regulatory guidelines to minimize risk for the organization. Supports coding infrastructure to ensure regulatory compliance in all aspects of coding and abstracting of clinical data to support patient care processes.
- This position has supervisory responsibilities for the Coding Team.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- 2 of coding experience
- Bachelor degree preferred
- CPC and Auditor Certification Preferred (AAPC)
- Extensive knowledge of coding principles and guidelines.
- Extensive knowledge of billing principles and guidelines.
- Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing for professional and technical services.
- Strong managerial, leadership, and interpersonal skills.
- Excellent written and oral communication skills
- Fluent in English and Spanish
- Excellent analytical skills
LICENSURES AND CERTIFICATIONS
- American Academy of Procedural Coders (AAPC) Certified Profession Coder (CPC) or American Health Information Management Association (AHIMA) Certified Coding Specialist (CCS).
- The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.
- Travel may be required.
We’re Making Healthcare Right. Together.
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.