Senior Coding and Reimbursement Auditor

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The pay range for this position is listed below. Actual pay rate dependent upon experience.

Position Highlights

You Belong at Avera

Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.

• Audits hospital/clinic coded charts on a predefined basis pre-bill and/or post bill encounters.
• Develops reports and/or education based on quality audit findings or requested risk areas and evaluates clinicians and coder coding performance.
• Audit activity may identify risks for escalation of specified service line audits.
• Meets with coders physicians and/or clinicians whose audits have revealed a pattern of performance gaps.
• Provides education to clinic/hospital coders based on findings from quality coding audits. Collaborates with departments and physician specialties as needed for clinical support on education topics
• May assist the compliance department with specific audit activities including support for outside agencies such as Recovery Audit Contractors (RAC) Medicare Administrative Contractors (MAC) and other payers on an as-needed or immediate basis.
• Provides consultant services to Avera affiliated partners as requested by coding leadership.
• Reviews coding disparities between health plans and the provider community to provide recommendations in coordination with managed care and coding leadership teams.
• Serves as an expert coding liaison who collaborates with AMG clinic managers revenue integrity revenue cycle billing teams charge master committee pro-fee audit team health information management managed care services and others as necessary.
• Helps improve physicians understanding of coding guidelines when necessary.

• Associates in health information from an American Health Information Management Association (AHIMA) accredited school preferred or an equivalent health care field accepted and/or equivalent combination education and experience.
• Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) Upon Hire or
• Registered Health Information Tech (RHIT) - American Health Information Management Association (AHIMA) Upon Hire or
• Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) Upon Hire or
• Certified Coding Specialist - Physician-based (CCS-P) - American Health Information Management Association (AHIMA) Upon Hire or
• Certified Inpatient Coder (CIC) - American Academy of Professional Coders (AAPC) Upon Hire or
• Certified Outpatient Coder (COC) - American Academy of Professional Coders (AAPC) Upon Hire or
• Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC) Upon Hire or
• Certified Risk Adjustment Coder (CRC) - American Academy of Professional Coders (AAPC) Upon Hire
• 4-6 years in multi-specialty coding coding auditing or related quality assurance work with ICD-10 and CTP code sets.

• Bachelors

• Commitment to the daily application of Averas mission vision core values and social principles to serve patients their families and our community.
• Promote Averas values of compassion hospitality and stewardship.
• Uphold Averas standards of Communication Attitude Responsiveness and Engagement (CARE) with enthusiasm and sincerity.
• Maintain confidentiality.
• Work effectively in a team environment coordinating work flow with other team members and ensuring a productive and efficient environment.
• Comply with safety principles laws regulations and standards associated with but not limited to CMS The Joint Commission DHHS and OSHA if applicable.

Benefits You Need & Then Some

Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced healthy lives. Benefits are designed to meet needs of today and into the future.

• PTO available day 1 for eligible hires.

• Up to 5% employer matching contribution for retirement

• Career development guided by hands-on training and mentorship

Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability Veteran Status or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application please call 1- or send an email to .