What are the responsibilities and job description for the Auditor Coder Lead position at MercyOne?
Overview
CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. & from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.
Responsibilities
ESSENTIAL FUNCTIONS:
MARGINAL FUNCTIONS:
Qualifications
MINIMUM KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:
CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. & from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.
Responsibilities
ESSENTIAL FUNCTIONS:
- Responsible for coding and abstracting patients’ records for professional billing.
- Reviews patient medical records retrospectively and concurrently for the coding and sequencing of diagnoses and procedures for reimbursement purposes.
- Interacts and assists with coding requests and questions from billers.
- Serves as a resource for difficult coding questions and assists with insurance denials for correction and re-filing.
- Makes process improvement recommendations to management as identified, specifically related to registration and charge posting.
- Performs in compliance with federal, state, insurance industry regulations.
- Follows established hospital policies concerning corporate compliance.
- Keeps abreast of insurance carrier rules and changes by participating in carrier specific and MCI education opportunities.
MARGINAL FUNCTIONS:
- Work includes cross coverage in other areas as team needs.
- Maintains supply inventory and stocks supplies in various work areas.
- Participates in Performance Improvement activities as appropriate.
- Maintains professional appearance of work area.
- Participates in staff development activities and orientation as requested.
- Other projects and assignments as required by supervisor.
Qualifications
MINIMUM KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:
- High school diploma or GED required.
- One to two years post high school education preferred.
- A minimum of two years current experience with ICDM 9, CPT coding, and health insurance provider rules and regulations required.
- Coding Certification required.
- Knowledge of anatomy and physiology and medical terminology required.
- Knowledge of physician EM coding desired
- Working knowledge of computer information systems required.
- Demonstrates professional, appropriate, effective and tactful written, verbal, and nonverbal communication with patient, families, medical staff, colleagues, vendors, and other departments throughout the continuum of care to promote continuity of care and services and enhance department image.
- Must be a self-starter and able to work independently and make appropriate decisions within hospital and departmental guidelines with little assistance from Manager.
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