Audit and Coding Consultant

78 HonorHealth Medical Group Support; United States; Hybrid; USD 75,000 - 110,000; Full time

Job summary

HonorHealth is seeking an Audit and Coding Consultant to audit, develop educational materials, and educate providers and coders on coding guidelines, researching new codes and reviewing growth opportunities.

Under senior leadership, you will ensure accuracy and compliance, train providers, work with IT to update codes for new services, and produce detailed reports of findings and required adjustments.

Qualifications

• Associates degree or 2 years' related experience required; Bachelor's degree preferred.
• 3 years Revenue Cycle experience required.
• 3 years Professional Coding experience required.
• 5 years coding leadership experience or equivalent preferred.

Responsibilities

• Audit and coding processes, develop educational materials and provide provider and coder training.
• Research regulations on new codes and review opportunities for growth; ensure coding accuracy through audits.
• Collaborate with IT and vendor to update codes for new services and prepare detailed reports with findings and necessary changes.

Skills

Revenue Cycle

Coding

Education materials

Provider training

Regulatory compliance

Education

Associates degree

Bachelor’s degree preferred

Job description

Primary City/State: Deer Valley - 2500 W Utopia Rd Phoenix, AZ 85027 Category: Health Information Shift: Day Department: Coding Hybrid position. Hours M-F. Hours 8a-5p, with ability to flex due to provider schedules for education sessions. Great care starts with great people. (Like you.) At HonorHealth, you’ll find something special. From humble beginnings in 1927 to one of Arizona’s largest nonprofit healthcare systems, our culture is built on warmth and neighborly kindness. Behind every smile is a highly skilled professional with deep expertise and an unwavering dedication to what matters most — caring for the health and well‑being of people and communities across the greater Phoenix area.

Responsibilities:

JOB SUMMARY Under the direction of senior leadership, the Audit and Coding Consultant audits, develops educational materials, educates providers and coders regarding coding/documentation guidelines. Research regulations on new codes and reviews opportunities for growth. Ensures accuracy and completeness of coding through a rigorous quality review of external and internal documentation of audit process ensuring compliance with federal and state regulations. Responsible for provider and coding training programs.

ESSENTIAL FUNCTIONS Ensure appropriate methodology to include financial controls, identification of trends and unusual patterns, reimbursement deficiencies, and to improve processes. Confirm appropriate services are provided in accordance with examination protocol and medical billing. Work with vendor to ensure audit processes maintain appropriate controls, providing feedback to both vendor and physicians regarding results. Identify unusual examiner patterns based on trends identifiable to the vendor/provider or coder. Identify deficiencies in the reimbursement process and opportunities for appropriate reimbursement. Provide a detailed report listing the findings and any adjustments required to the invoices for all inappropriately invoiced services. Make recommendation for improvements in processes or policies and create/execute provider education for individuals and/or group sessions. Maintain audit results and ensure provider movement throughout the compliance audit plan. Analyze and confirm external results and as appropriate, which with senior leadership and compliance to create action plans. Research guidelines and regulations for proposed lines of business. Keep revenue cycle and physicians updated on new or changing regulations. Work with IT to ensure that codes are updated and build for new services include required data points. Performs other duties as assigned.

Education

Associates or 2 years' work related experience Required Bachelors Preferred

Experience

3 years, Revenue Cycle experience Required 3 years, Professional Coding experience Required 5 years, coding leadership experience or equivalent Preferred

License and Certifications

• Certified Professional Coder (CPC) - Certification, Required
• Professional Coding Auditor - Certification, Preferred

We're all in for your career. Expert care from experts who care. At HonorHealth, you’ll find something special. Our culture is built on warmth and neighborly kindness, but behind every smile is a highly skilled professional with deep expertise and unwavering dedication. We’re delivering a healthcare experience that simply feels better through:

• Nine acute‑care hospitals
• Over 200 primary, specialty and urgent care centers
• More than 17,000 team members and 4,000 medical staff

Since 1927, we’ve been focused on doing what matters most — caring for people and communities across the greater Phoenix area. From humble beginnings to one of Arizona’s largest nonprofit healthcare systems, we’re just as driven as we were a century ago. Come join us and go all in for your career.

Important:

IMPORTANT: HonorHealth is committed to providing an excellent candidate experience for candidates interested in our job opportunities. We also care about the online safety of our job seekers. Please note the following: HonorHealth employee emails come from HonorHealth (i.e [e-mail]) not a generic email address, such as gmail or yahoo. If you are suspicious of a job posting, or if you receive any email from an HonorHealth employee that you believe to be fictitious, please contact us [e-mail]. HonorHealth does not use Google Hangouts to conduct interviews or conversations. HonorHealth will not ask you to provide any personal information (i.e. drivers license, bank account, credit card information, passwords, social security number) outside of our Applicant Tracking Software before a job offer is extended. If you believe that HonorHealth has violated your civil rights or believe you have experienced discrimination, please click the link to obtain information on your rights to file a complaint. For more information, please click here.