Medical Coder Compliance Specialist

University of Michigan Flint; Ann Arbor (MI); Hybrid; USD 70,000 - 100,000; Full time

Benefits offered by this job

Excellent health benefits

Retirement match (2:1)

Hybrid/remote work options

Job summary

University of Michigan Michigan Medicine is seeking a Coding Compliance Auditor to perform outpatient coding quality audits ensuring CPT/HCPCS, ICD-10-CM code assignments and modifiers align with CMS guidelines. You will provide ongoing feedback to the coding staff and develop educational programs for the outpatient coding department.

The ideal candidate holds CPC/COC/RHIT/RHIA/CCS/CCS-P credentials, an associate degree in healthcare, and at least three years of coding/auditing experience, with

Qualifications

• Associate's degree in healthcare or equivalent experience.
• CPC/COC/RHIT/RHIA or CCS/CCS-P credential required.
• Three years of coding or auditing CPT, ICD-10-CM, and modifier assignment.

Responsibilities

• Perform pre/post bill chart reviews to validate coding accuracy per guidelines.
• Provide workflow training to new hires and ongoing coder education.
• Review coding clinics and AMA/NCCI guidelines to prepare education sessions.
• Develop Policies & Procedures related to Revenue Cycle Mid-Service maintenance.
• Respond to internal/external inquiries about coding processes and documentation.

Skills

CPT/ICD-10-CM coding

Auditing & education

Communication & problem-solving

Education

Associate's degree in healthcare related field

CPC/COC/RHIT/RHIA/CCS/CCS-P

Job description

Coding Compliance Auditor Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.Perform coding quality audits on outpatient records to assure appropriateness, accuracy, and compliance for CPT/HCPCs, ICD-10-CM code assignments, and modifier assignment in accordance with Center of Medicare and Medicaid Service (CMS) Guidelines, AMA and AHA Official ICD-10-CM Coding Guidelines. Provide ongoing feedback to managers and coders. Develop and implement educational programs regarding elements of the coding compliance program and act as a subject matter expert for the outpatient coding department.

Responsibilities

Perform pre and/or post bill secondary chart review to validate modifier selection, E&M, procedural, and diagnosis coding in accordance with established coding guidelinesProvide workflow and coding training to new hiresContinuously provide feedback to coding staff to improve code selections that accurately describe the procedures and services performed by physicians in accordance to NCCI, AMA/CPT & ICD 10- guidelinesReview and Dissect coding clinics, yearly AMA guidelines, ICD-10-CM and NCCI to prepare education sessions to outpatient coders. Develop and coordinate educational and training programs regarding elements of the Coding Compliance Program, such as appropriate documentation, accurate coding, and coding trends found during chart reviews. Respond to complex internal and external customer inquiries in relation to Mid-Service processes, documentation, and coding compliance standards. Participate in process improvement initiatives by use of technologyRevise and/or write Policies & Procedures related to Revenue Cycle Mid-ServiceAssist with coding in the event of an unplanned emergencyDemonstrate initiative by the continuous expansion of knowledge and skillsParticipate in department/unit activities including, but not limited to, staff meetings and in-servicesPerform other duties as assigned to maintain the efficiency of the departmentProtect the confidentiality of primary and secondary health records and the information therein as mandated by law, professional standards, and Health System policiesDemonstrates excellent customer service skills in working with Revenue Cycle staff, clinicians, and other UHMS staff. Model, support and reinforce a culture of service excellence

SKILLS

Extensive CPT/ ICD-10-CM coding knowledge with a strong understanding of the AMA, AHA and NCCI Official Coding Guidelines and how to apply them.Ability to leverage technology for process improvement.Analyze guidelines to provide in-depth education to staff.Write appropriate queries to the clinical care team in accordance with the AHIMA Query Policy.Attention to detail with thoroughness and accuracy when accomplishing a task.Participate as an active member of Lean Thinking in daily work initiativesExcellent verbal and written communication skills, analytical thinking, and problem-solving skills with attention to detail are required.Proficiency in organizational skills and planning with an ability to juggle multiple priorities in a fast-changing environmentExperience in developing and providing education to coders and physiciansAbility to work independently, be self-motivated, and the ability to adapt to the changing healthcare environment.

Required Qualifications

Associate's degree in healthcare related field or an equivalent combination of education and/or experience.Certified Professional Coder (CPC), or Certified Outpatient Coder (COC), or Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS/CCS-P) credential.Three years' experience coding or auditing CPT, ICD-10-CM, and modifier assignment.Extensive knowledge of federal and state regulations and policies pertaining to documentation and coding.

Michigan Medicine is one of the largest health care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School in 1850. Michigan Medicine is comprised of over 30,000 employees and our vision is to attract, inspire, and develop outstanding people in medicine, sciences, and healthcare to become one of the world’s most distinguished academic health systems. In some way, great or small, every person here helps to advance this world-class institution. Work at Michigan Medicine and become a victor for the greater good.

What Benefits can you Look Forward to?

Excellent medical, dental and vision coverage effective on your very first day 2:1 Match on retirement savings

Modes of Work

Mobile/Remote - the work requirements allow for the majority or all the work to be completed offsite. On occasion, the employee may be required and must be available to work onsite if necessitated by unit leadership or their designee and/or the job requirements. Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.

Background Screening

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

Application Deadline

Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.

U-M EEO Statement

The University of Michigan is an Equal Opportunity Employer. We are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants, including protected veterans and individuals with disabilities.