Laboratory Coding Auditor/Educator

Carle; Champaign (IL); Hybrid; USD 35,000 - 58,000; Full time

Job summary

Carle Health in Illinois is seeking a Laboratory Coding Auditor/Educator to oversee coding audits and provide targeted education for Laboratory Billing & Coding Representatives, Pathologists, and departments. This senior resource ensures compliant code assignment and accurate transmission to EPIC.

You will lead audits, train staff, monitor performance, and stay current with coding regulations, partnering with leadership to improve charge integrity and workflow.

Qualifications

• RHIT certification required.
• CPC certification required.
• High school diploma or GED required.
• Experience in coding

Responsibilities

• Perform essential duties of Laboratory Billing & Coding Representative.
• Assist Audit Manager in audits and audit scheduling.
• Provide coding audits to staff and Pathologists for CPT, HCPCS, modifiers, and place of service.
• Provide education in one-on-one or group formats to team members and Pathologists.
• Conduct billing workflow and charge integrity audits to ensure orders and charges transmit to EPIC.
• Track statistics related to the audit process.
• Serve as senior coding resource for the department.
• Train new billing staff in laboratory coding and billing practices.
• Attend meetings with Pathologists, LIS, Revenue Cycle, and HIM on coding/auditing topics.
• Interpret billing data to identify performance gaps and benchmarks.
• Maintain knowledge of current coding regulations and update team accordingly.
• Identify root causes of denials and advise leadership on improvements.
• Collaborate with laboratory departments and other units to support accurate system configuration.

Education

RHIT

CPC

High school diploma or GED

Job description

Overview

The Laboratory Coding Auditor/Educator assists with oversight of coding audits and delivers targeted education for the Laboratory Billing & Coding Representatives, Pathologists, and applicable departments. This role works closely with and supports Laboratory leadership to ensure regulatory and compliance requirements are met for appropriate code assignment, while serving as a senior coding resource for the department. The Auditor/Educator conducts billing workflow and charge integrity audits to ensure laboratory orders and charges accurately transmit to EPIC. The Auditor/Educator adheres to all duties of the Laboratory Billing & Coding Representative.

Qualifications

Certifications: Registered Health Information Technician (RHIT) - American Health Information Management Association(AHIMA); Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC),

Education: Highschool Diploma or G.E.D , Work Experience: Coding

Responsibilities

• Must be able to perform essential job functions of Laboratory Billing & Coding Representative.
• Assists Laboratory Revenue Integrity & RCM Manager in managing audits and audit schedules.
• Provides coding audits to Laboratory Coding & Billing Representatives and Pathologists specific to CPT, HCPCS, modifier, and place of service coding.
• Provides education as needed, either one-on-one or group format to team members and Pathologists.
• Provides billing workflow and charge integrity audits to ensure laboratory orders and charges accurately transmit to EPIC.
• Compiles and tracks statistics related to the audit process.
• Serves as senior coding resource for department.
• Responsible for training new billing staff in laboratory coding and billing practices.
• Attend meetings as required with Pathologists, LIS, Revenue Cycle, and HIM on topics related to coding and auditing.
• Supports manager by interpreting and analyzing billing data to identify and monitor performance and established benchmarks for the department.
• Maintains knowledge of current and required coding regulations and assures team members are updated as regulations change.
• Trends coding-related denials, identifies root causes, and advises leadership on opportunities to resolve trends.
• Builds collaborative relationships with laboratory departments, pathologists, LIS, Revenue Cycle Systems, and other departments to support accurate system configuration.
• Tracks and trends all role functions for reporting purposes.
• Meet with Manager of Laboratory Revenue Integrity & RCM to review audits and attend meetings as required on topics related to coding and auditing education needs and follow up.
• Work with Laboratory Leadership to establish coding guidelines and assure coding team audits are completed timely.
• Report compliance or other concerns directly to Laboratory Leadership as needed or indicated.

About Us

Find it here.

Discover the job, the career, the purpose you were meant for. At Carle Health, we're committed to fostering a workplace where every team member feels valued, respected and empowered, where passion and purpose come together to positively impact the lives of our patients and our communities. Find it all at Carle Health.

Our nearly 17,000 team members and providers work together to support patient care across central and southeastern Illinois. We’ve grown to include eight, award-winning hospitals and a multispecialty provider group with more than 1,500 doctors and advanced practice providers. We’re developing the next generation of providers and healthcare professionals through Carle Illinois College of Medicine, the world’s first engineering-based medical school, and Methodist College. Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital, Carle Health Pekin Hospital, and Carle Hoopeston Regional Health Center hold Magnet® designations, the nation’s highest honor for nursing care. We offer opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: [e-mail].

Compensation and Benefits

The compensation range for this position is $25.18per hour - $42.05per hour. This represents a good faith minimum and maximum range for the role at the time of posting by Carle Health. The actual compensation offered a candidate will be dependent on a variety of factors including, but not limited to, the candidate’s experience, qualifications, location, training, licenses, shifts worked and compensation model.

Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org/benefits.