Physician Coding Auditor

Ensemble Health Partners; United States; On-site; USD 57,000 - 99,000; Full time

Benefits offered by this job

Bonus incentives

Paid certifications

Tuition reimbursement

Comprehensive benefits

Career advancement

Job summary

Ensemble Health Partners seeks an experienced Physician Coding Auditor to lead coding and training initiatives across clinical specialties, ensuring compliance with coding standards and client SOWs.

You will review inpatient and outpatient accounts, educate staff, and support audits and denials handling. Travel to client sites may be required; remote work is supported with onsite visits as needed.

Qualifications

• 5+ years of coding experience.
• 3+ years of auditing experience.
• Proficiency in multiple EMR’s, encoders, and the Microsoft Office suite.
• Educated in HIPAA regulations; must maintain strict confidentiality of patient and client information.
• Ability to read, write and effectively communicate in English.
• Above average written and verbal communication skills.

Responsibilities

• Quality Review - Monitors and audits inpatient and outpatient accounts across the system.
• Educating - Assesses educational needs and develops programs or resources.
• Edits/Denials/Coding - Assists with edits, denials and appeals.
• Training - Develops training materials and coding aids for formal training.
• Coordinating - Coordinates ongoing seminars and materials via webinars and publications.
• Resource - Serves as a technical resource and maintains current coding standards.
• Reporting - Provides reports of audit findings to management and providers.

Skills

Auditing

Coding

English communication

Medical terminology

Confidentiality

EMR proficiency

Encoders

MS Office

Education

Associates degree or equivalent

Tools

EMR systems

Encoders

Microsoft Office

Job description

• Comprehensive Benefits

Thank you for considering a career at Ensemble!

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.

Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!

O.N.E Purpose

• Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
• Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
• Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.

The Opportunity

CAREER OPPORTUNITY OFFERING

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement
• This position pays between $57,400 to $99,000 annually based on experience

The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards. Ability to code and a clear understanding of the coding principles and guidelines for various specialties including Neurosurgery, Intervention Radiology, ENT, General Surgery, Cardiology, Anesthesia, Emergency Department.

Job Responsibilities

• Quality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at HIM facility coding for both inpatient and outpatient accounts. Performs annual performance, randomized and quality assurance reviews to assess comprehension of training efforts. Also assists in CHAN and other external audits.
• Educating - Assesses the educational needs of coding staff and providers that are contracted/employed and outlined in the client SOW (included Provider Education verbiage) and develops programs or researches educational resources to meet those needs. Assists with Task Force, CDE and quality department related education. Creates presentations, develops learning material, handbook and other educational materials.
• Edits/Denials/Coding - Assists with edits, denials and appeals. Also assists with coding and working holds on an as needed basis.
• Training - Assists with training new and existing staff. Develops all training materials and coding aids for both formal training and use by coders in daily work. Identifies coders to be cross-trained and suggests areas for training improvement. Assists in the implementation and administration of effective systems, processes, and procedures.
• Coordinating - Coordinates the presentation of ongoing professional seminars and materials via audio-conferences, webinars, and other publications. Maintains education records on all staff to include attendance records for all coding related educational activities.
• Resource - Serves as a technical resource for all involved personnel; ensures that information is accurate and current, meeting professional coding standards. Performs miscellaneous job-related duties as assigned.
• Reporting - Provides reports of audit findings to coding management, individual coders and leadership as needed/requested along with providers that are contracted/employed and outlined in the client SOW (Included Provider verbiage). Assists with the creation of various documents and reports as requested. Immediately provides reports related to compliance risks when requested.

Experience We Love

• 5+ years of coding experience.
• 3+ years of auditing experience.
• Proficiency in multiple EMR’s, encoders, and the Microsoft Office suite.
• Educated in HIPAA regulations; must maintain strict confidentiality of patient and client information.
• Consistently achieves quality and productivity standards.
• Ability to organize and complete work in a timely manner.
• Ability to read, write and effectively communicate in English.
• Ability to understand medical/surgical terminology.
• Above average written and verbal communication skills.
• Position may require 20-40% travel to client sites.
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.
• This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.

Minimum Education

• Associates Degree or Equivalent Experience

Required Certifications

Candidates must have and keep current at least one of the following professional certifications (CPC, CPMA or CCS Preferred):

• CPC (Certified Professional Coder)
• CCS-P (Certified Coding Specialist-Phys Based)
• CCS (Certified Coding Specialist)
• CMPA (Certified Professional Medical Auditor)
• RHIA (Registered Health Information Administrator)RHIT (Registered Health Information Technician)

Join An Award-winning Company

Five-time winner of “Best in KLAS” 2020-2022, 2024-2025

Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024

22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024

Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024

Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023

Energage Top Workplaces USA 2022-2024

Fortune Media Best Workplaces in Healthcare 2024

Monster Top Workplace for Remote Work 2024

Great Place to Work certified 2023-2024

• Innovation
• Work-Life Flexibility
• Leadership
• Purpose + Values

• Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
• Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories.

Due to business, operational, payroll, and regulatory requirements, this position is limited to individuals who reside and are authorized to work within the United States. Applications generated from outside the United States will not be considered. Individuals may reapply when located within the United States.

Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law.

This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.