Physician Coding Quality Auditor, PBO Coding, Full Time, 1st shift

At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.

As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors.

UC Health is committed to providing an inclusive, equitable and diverse place of employment.

Responsibilities

1. Performs daily/weekly/monthly quality control, including reviews, corrections and feedback on timeliness, accuracy and compliance of abstracting and coding of patient accounts.
2. Audits Accounts
3. Staff Education
4. DRG Opinions
5. Coding Accounts
6. Develops Audit Reports
7. Performs routine and focused coding audits on inpatient and outpatient accounts.
8. Reviews coding audit results with coding staff and considers feedback from the coders as appropriate. Enters and maintains audit results data.
9. Works with the coding education coordinators and managers to provide educational sessions for coding staff concerning issues identified through the auditing process.
10. Responds to coder questions and reviews cases as necessary, to assist with correct code assignment.
11. Attends educational sessions, training sessions and task forces sessions as directed.
12. Reviews and submits professional opinion on DRG denials submitted by government and third party auditors. Provides response and supporting documentation when necessary.
13. Assists with coding when necessary to help reduce the Accounts Receivable on unbilled accounts and improve status.
14. Assists with providing research results and correction of coding errors and issues.
15. Tracks, reports and effectively communicates audit findings including reimbursement and compliance information.
16. Provides information to Administration, Revenue Cycle, Charge Master, and Quality Management teams to communicate overall coding performance and to address issues where appropriate.

Qualifications

Minimum Required: HS Diploma/GED. | Required: CPC. Preferred: CPMA. | Minimum Required: 5 years.