Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).
The Sr. Auditing Consultant accurately examines and evaluates the medical record and health information for accuracy in coding for hospital outpatient and physician coding.
Responsibilities:
- Performs ambulatory surgery, emergency room, other hospital outpatient visits, and evaluation/management coding audits for technical and/or professional reporting
- Performs educational services to clients based on audit results
- Has the ability to analyze audit results identifying patterns, trends, and key problematic areas with the ability to communicate specific opportunities for coder improvement initiatives
- Utilizes a laptop/or micro desk top computer in a virtual office, windows-based environment
- Utilize various coding books, procedure manuals, and on-line encoders as a resource
- Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
- May be asked to mentor other new consultants and perform peer reviews
- Maintains strict patient and physician confidentiality and follows all federal, state and hospital guidelines for release of information
- Maintains current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols
- Participate in staff meetings, training and conference calls as requested
Client Specific Responsibilities:
Perform coding QA reviews based on Client’s internal monitoring process, criteria, and requirements including quality outcomes data entry and reporting as follows:
- Include appropriate assignment of the CPT procedure charges based on supporting
medical record documentation and established coding guidelines;
- Review for accurate assignment of any and all applicable modifiers based on official
reporting guidelines;
- Review for accurate and appropriate application of Correct Coding Initiative Edits
- (“NCCI”) against reported CPT codes included in this scope;
Identify areas of educational opportunities for coders and/or providers in relation to CPT
code assignments, as applicable;
- Communicate recommendations for documentation and/or process improvement as they are identified;
- Define areas and topics in which additional education would be beneficial for increased
accuracy and compliance; and
- Complete the charge review and return the case electronically within a timely manner unless additional information is needed from the Client.
Minimum Qualifications
- RHIA, RHIT, CCS, CCS/P or CPC
- Certified Interventional Radiology Cardiovascular Coder (CIRCC)
- 3+ years’ experience including outpatient and/or professional fee coding skills as well as ambulatory surgery, APC, emergency room, evaluation and management, auditing, report-writing expertise, required. Must be proficient in all aspects of Interventional Radiology (IVR) procedures
- Preferred coding skills: prospective payment methodologies, physician office billing
- Must successfully pass a coding skills assessment
- Knowledge of medical terminology, ICD-10 and/or CPT-4 codes
- Must be detail oriented and have the ability to work independently
- Computer knowledge of MS Office
- Must display excellent interpersonal skills
- Must have effective communication and writing skills
Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $72,000 to $77,000 per hour. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.
SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.
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