HIM Coding & Reimbursement Auditor - Impact & Education

Avera; Sioux Falls (SD); On-site; USD 41,000 - 63,000; Full time

Benefits offered by this job

PTO from day 1

Retirement matching up to 5%

Career development and mentorship

Job summary

Avera is seeking an Auditor to support health information management departments with ICD-10, CPT, and HCPCS coding review, DRG and APC reimbursement, and coordination of information between medical records and billing. The role includes developing educational workshops for Avera and non-Avera facilities, and ensuring regulatory alignment at state and federal levels.

The successful candidate will audit charts, provide consultant services on coding issues, deliver trainings, and liaise across

Qualifications

• Associate's in Health Information Management or related field.
• RHIA/RHIT/CCS/CCS-P/CIC/COC/CPC/CRC AHIMA/AAPC certifications upon hire.
• 4-6 years experience in multi-specialty coding, coding auditing, or related quality assurance work with ICD-10 and CPT code sets.

Responsibilities

• Audits hospital/clinic coded charts and provides written reports with findings and recommendations.
• Analyzes financial impact following audit activities based on PPS, CAH and Professional Physician services.
• Provides consultant services to non-Avera Health facilities on ICD-10, CPT, and HCPCS coding and reimbursement issues.
• Provides and coordinates education to coders, physicians and hospital staff on coding and billing findings with detailed reports for tracking.
• Presents in-service education to coders, coding teams, physicians, other clinicians, Avera committees, leadership and others when necessary.
• Assists in communication between health information management and billing departments and between hospitals, clinics and ambulatory care facilities.

Skills

Auditing

Healthcare coding

Data analysis

Communication

Education

Associate's in Health Information Management

RHIA - AHIMA

RHIT - AHIMA

CCS - AHIMA

CCS-P - AHIMA

CIC - AAPC

COC - AAPC

CPC - AAPC

CRC - AAPC

Bachelor's in Health Information Management (preferred)

Job description

Avera is seeking an Auditor to support health information management departments with ICD-10, CPT, and HCPCS coding review, DRG and APC reimbursement, and coordination of information between medical records and billing. The role includes developing educational workshops for Avera and non-Avera facilities, and ensuring regulatory alignment at state and federal levels.

The successful candidate will audit charts, provide consultant services on coding issues, deliver trainings, and liaise across