Coding Auditor
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OSF HealthCare
Peoria, IL, US
Summary
The Coding Auditor performs quality and integrity reviews of coding data to ensure compliance with ICD-10, CPT, and governmental guidelines. They also manage external audits and DRG billing denials by writing appeals and defending coded data based on provider documentation.
Job Description
Total Rewards
OSF HealthCare is dedicated to provide Mission Partners with a comprehensive and market-competitive total rewards package that includes benefits, compensation, recognition and well-being offerings that focus on the whole person and engage with their current stage of life and career. Click here to learn more about benefits and the total rewards at OSF.
Expected pay for this position is $29.01 - $34.13/hour. Actual pay will be determined by experience, skills and internal equity. This is an Hourly position.
Overview
Candidates in Illinois
Full Remote Near OSF location
POSITION SUMMARY:
The Coding Auditor is responsible for performing coding and documentation reviews to ensure the quality and integrity of coding data captured for OSF services. Provides validation of accurate and compliant coding and charging to ensure adherence to established coding guidelines of ICD-10, CPT, governmental and third-party payers; ensuring coding quality standards are achieved and maintained. Responds to external coding audits and DRG billing denials, writing appeals, documenting coding rationale and defends OSF coded data based on provider documentation and coding rule and convention as appropriate. Research coding and/or billing code requirements using encoders and various professional and government publications in order to achieve compliance and optimize reimbursement. Participates in productive coding workflows in order to maintain up to date knowledge of current documentation and coding software toolset.
Qualifications
REQUIRED QUALIFICATIONS:
Education: Associates degree in Health Information Management OR Bachelor’s degree in applicable health related field.
Licensure/Certifications: Must have one of the following certifications: RHIA (Registered Health Information Administrator) RHIT (Registered Health Information Technician) CCS (Certified Coding Specialist) CMA (Certified Medical Office Assistant) CPC (Certified Professional Coder) OR will obtain AHIMA- CCS certification within 12 months of hire.
Experience: 3 years of experience in hospital or professional coding.
Other skills/knowledge: Advanced knowledge of ICD10-CM/PCS and CPT/HCPCS coding guidelines Knowledge of medical terminology, anatomy/physiology, disease processes, medical records and hospital procedures.
Ability to concentrate on a task over a period of time without being distracted Basic keyboard and software application skills, including Electronic Medical Record systems. Demonstrated ability to communicate effectively via written and verbal means Demonstrated excellent professional writing skills. Analytical skills necessary in collecting, analyzing, and reporting departmental quality indicators ensuring compliance with regulatory data requirements, establishing coding area goals and assessing outside coding review activities.
PREFERRED QUALIFICATIONS:
Fluency with advanced understanding of both MS and APR DRG methodologies.
Direct experience with chart quality audits and/or denial response writing.
OSF HealthCare is an Equal Opportunity Employer.
OSF HealthCare is an integrated health system founded by The Sisters of the Third Order of St. Francis and headquartered in Peoria, Illinois. The system includes 18 inpatient facilities encompassing 16 licensed hospitals, two of which operate dual campuses in separate communities. Among these hospitals, 10 are acute care facilities, five are critical access hospitals and one is a continuing care facility. OSF has 2,141 licensed beds throughout Illinois and Michigan.
OSF employs more than 27,000 Mission Partners across 170+ locations. These include OSF HealthCare Children’s Hospital of Illinois, the third largest pediatric hospital in the state, and OSF OnCall, its digital health operating entity that offers hospital-at-home care. In addition, OSF operates two colleges of nursing; OSF Home Care Services, an extensive network of home health and hospice services; Pointcore, Inc., which is composed of health care-related businesses; and OSF HealthCare Foundation, the philanthropic arm of the organization. Advances in health care transformation take place through OSF Innovation as well as OSF Ventures, which provides investment capital for promising health care innovation startups.
OSF HealthCare has been recognized by Fortune as one of the most innovative companies in the country. That same commitment to innovation extends to how OSF supports and invests in its Mission Partners. OSF consistently earns recognition for showing dedication to Mission Partner well-being:
•America’s Best-in-State Employers | Forbes Magazine | 2018-2026
•150 Top Places to Work in Healthcare | Becker’s Healthcare | 2019, 2022-2025
•Best Employers for Women | Forbes Magazine | 2020
OSF HealthCare is an Equal Opportunity Employer (EOE).
By engaging with this page, you acknowledge and agree to follow our social media terms of use, which you can find here: https://www.osfhealthcare.org/patients-visitors/terms-conditions/social-terms
Company size
10,001+ employees
Industry
Hospitals and Health Care
Org type
Nonprofit
Headquarters
Peoria, Illinois
OSF HealthCare is an integrated health system founded by The Sisters of the Third Order of St. Francis and headquartered in Peoria, Illinois. The system includes 18 inpatient facilities encompassing 16 licensed hospitals, two of which operate dual campuses in separate communities. Among these hospitals, 10 are acute care facilities, five are critical access hospitals and one is a continuing care facility. OSF has 2,141 licensed beds throughout Illinois and Michigan.
OSF employs more than 27,000 Mission Partners across 170+ locations. These include OSF HealthCare Children’s Hospital of Illinois, the third largest pediatric hospital in the state, and OSF OnCall, its digital health operating entity that offers hospital-at-home care. In addition, OSF operates two colleges of nursing; OSF Home Care Services, an extensive network of home health and hospice services; Pointcore, Inc., which is composed of health care-related businesses; and OSF HealthCare Foundation, the philanthropic arm of the organization. Advances in health care transformation take place through OSF Innovation as well as OSF Ventures, which provides investment capital for promising health care innovation startups.
OSF HealthCare has been recognized by Fortune as one of the most innovative companies in the country. That same commitment to innovation extends to how OSF supports and invests in its Mission Partners. OSF consistently earns recognition for showing dedication to Mission Partner well-being:
•America’s Best-in-State Employers | Forbes Magazine | 2018-2026
•150 Top Places to Work in Healthcare | Becker’s Healthcare | 2019, 2022-2025
•Best Employers for Women | Forbes Magazine | 2020
OSF HealthCare is an Equal Opportunity Employer (EOE).
By engaging with this page, you acknowledge and agree to follow our social media terms of use, which you can find here: https://www.osfhealthcare.org/patients-visitors/terms-conditions/social-terms
Company size
10,001+ employees
Industry
Hospitals and Health Care
Org type
Nonprofit
Headquarters
Peoria, Illinois