Coding Auditor (Hybrid), Day Shift, Revenue Integrity

Adventist HealthCare; Gaithersburg (MD); Hybrid; USD 65,000 - 92,000; Full time

Job summary

Adventist HealthCare's Revenue Integrity department seeks an experienced Coding Auditor to support charge capture accuracy and reimbursement. The role emphasizes analyzing billing edits, managing work queues, and collaborating with clinical leadership to drive compliant coding practices.

The ideal candidate has extensive ICD-10/CPT knowledge, familiarity with denials management, and experience with 3M Encoder and EHR systems.

Qualifications

• Extensive knowledge of ICD-10, CPT coding, Evaluation and Management Codes, modifiers, Coding Clinic and CPT Assistant.

Responsibilities

• Leads discussions and educational sessions with stakeholders to improve revenue goals.

Skills

ICD-10 coding

CPT coding

Denials management

CMS rules

HIPAA compliance

3M Encoder

Microsoft Office

Cerner / eCW familiarity

anatomy terminology

problem solving

Education

High School or GED

CCS certification

CCS-P certification

CPC certification

RHIA preferred

RHIT preferred

Tools

3M Encoder

Cerner

eCW

Job description

Support Center

Adventist Healthcare's Support Center seeks to hire an experienced Coding Auditor for our Revenue Integrity department who will embrace our mission to extend God’s care through the ministry of physical, mental, and spiritual healing.

As a Coding Auditor, you will:

• Leads discussions and educational sessions, with manager support, with various impacted Revenue Integrity stakeholders. to improve overall revenue goals and departmental needs.
• Analyzes and resolves billing edits and bill holds for areas impacted by coding
• Manages assigned work queues and associated tasks to review, analyze, and provide corrective action.
• Maintains work queues at agreed-upon levels to keep on task with department goals and objectives
• Escalates barriers or concerns to the manager in a timely clearly articulated and documented format
• Performs EHR analyses and research along with associated patient accounting, medical charting, and system interfacing to examine and understand underlying root causes of charge capture delays and reconciliation challenges
• Performs root cause analyses on trends and systemic barriers and presents findings to leadership
• Assess Present on Admission (POA) indicators at AHC facilities
• Communicate with clinical practices and providers in a productive and professional manner
• Provide support to the Director, Manager, and Coordinators in their efforts to collaborate with AHC entities, physicians, physician practices, CMOs, CDI, and other stakeholders in understanding the impact of coding on care quality, documentation, and reimbursement.

Qualifications include:

• Extensive knowledge of ICD-10, CPT coding, Evaluation and Management Codes, modifiers, Coding Clinic and CPT Assistant
• Experience with Denials Management as it pertains to coding experience and assessing related denials
• Working knowledge of anatomy, medical and procedural terminology
• Strong knowledge of medical billing practices
• Familiarity with bill hold edits for coding concerns and questions
• Extensive knowledge of 3M Encoder
• Proficiency in Microsoft Office, including Outlook, Word, PowerPoint, and Excel; fluency in Cerner and/or eCW is desirable.
• Strong attention to detail and accuracy, using problem-solving skills and analytical thinking.
• Understands and can apply CMS rules and regulations
• Understanding and compliance with HIPAA laws and regulations
• Understand query practice and guidelines and appropriate ways to communicate with coding vendors, other coding expertise, and clinicians
• Strong experience with patient accounts audits and accuracy are required.
• Good organizational, written, and verbal communication skills
• Ability to perform comfortably in a fast-paced, deadline-oriented work environment.
• Ability to work as an independent contributor.
• High School or GED
• 3+ years of coding experience in a hospital or medical practice setting
• Certified in CCS, CCS-P, or CPC
• RHIA, RHIT preferred.

Work Schedule:

• Employment Type: Full-time
• Hours per Week: 40 hrs/week
• Typical Daily Schedule: Day Shift/ Hybrid
• Shift Type: Day
• Holiday Requirements: Follow the company holiday calendar

Pay Range

$26.91 - $39.03

If the salary range is listed as $0 or if the position is Per Diem (with a fixed rate), salary discussions will take place during the screening process.

Under the Fair Labor Standards Act (FLSA), this position is classified as:

United States of America (Non-Exempt)

At Adventist HealthCare our job is to care for you.

• Work life balance through nonrotating shifts
• Recognition and rewards for professional expertise
• Free Employee parking
• Medical, Prescription, Dental, and Vision coverage for employees and their eligible dependents effective on your date of hire
• Employer-paid Short & Long-Term Disability, Basic Life Insurance and AD&D, (short-term disability buy-up available)
• Paid Time Off
• Employer retirement contribution and match after 1-year of eligible employment with a 3-year vesting period
• Voluntary benefits include flexible spending accounts, legal plans, and life, pet, auto, home, long term care, and critical illness & accident insurance
• Subsidized childcare at participating childcare centers
• Tuition Reimbursement
• Employee Assistance Program (EAP) support

As a faith-based organization, with over a century of caring for the communities in the Maryland area, Adventist HealthCare has earned a reputation for high-quality, compassionate care. Adventist HealthCare was the first and is the largest healthcare provider in Montgomery County.

If you want to make a difference in someone’s life every day, consider a position with a team of professionals who are doing just that, making a difference.

COVID-19 Vaccination

Adventist HealthCare strongly recommends all applicants to be fully vaccinated for COVID-19 before commencing employment. Applicants may be required to furnish proof of vaccination.

Tobacco and Drug Statement

Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, Adventist HealthCare will not hire applicants for employment who either state that they are nicotine users or who test positive for nicotine and drug use.

While some jurisdictions, including Maryland, permit the use of marijuana for medical purposes, marijuana continues to be classified as an illegal drug under the federal Controlled Substances Act. As a result, medical marijuana use will not be accepted as a valid explanation for a positive drug test result.

Adventist HealthCare will withdraw offers of employment to applicants who test positive for Cotinine (nicotine) and marijuana. Those testing positive are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing. ("Nicotine products" include, but are not limited to: cigarettes, cigars, pipes, chewing tobacco, e-cigarettes, vaping products, hookah, and nicotine replacement products (e.g., nicotine gum, nicotine patches, nicotine lozenges, etc.).

Equal Employment Opportunity

Adventist HealthCare is an Equal Opportunity/Affirmative Action Employer. We are committed to attracting, engaging, and developing the best people to cultivate our mission-centric culture. Our goal is to have a welcoming, equitable, and safe place to work and grow for all employees, no matter their background.

AHC does not discriminate in employment opportunities or practices on the basis of race, ethnicity, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, pregnancy and related medical conditions, protected veteran status, or any other characteristic protected by law.

Adventist HealthCare will make reasonable accommodations for applicants with disabilities, in accordance with applicable law. Adventist HealthCare is a religious organization as defined under applicable law; however, it will endeavor to provide reasonable accommodations for applicants’ religious beliefs. Applicants who wish to request accommodations for disabilities or religious belief should contact the Support Center HR Office.