Coding Auditor Educator - Revo Health

The Coding Auditor/Educator – Multi-specialty will assure consistent quality coding and training in evaluation and management, office procedures, and surgical coding through ongoing internal audits, training and education while adhering to official coding guidelines, in support of federal, state, local, and department requirements.

This is a full-time role, flexible, remote, core business hours, 8:00 AM - 4:30 PM office out of Bloomington, MN.

Revo Health is a professional services company that partners with multiple healthcare groups to deliver exceptional patient care. This position will be employed through Revo Health, working closely with Infinite Health Collaborative (i-Health) and its operating divisions.

Essential Functions:

• Training and development of current and newly hired remote and on-site coding team members.


• Perform quality assurance reviews to assess comprehension of training efforts.


• Training and continued development based upon internal and external audit results to expand coding expertise and assure coder corrections are made.


• Serve as clinical coding subject matter expert utilizing critical thinking to analyze and evaluate documentation issues via research, consultation with clinical staff, Coding leadership and Coding Specialists. 


• Audit coders based on provider documentation verifying ICD-10, CPT-4 and HCPCs codes for clinic, outpatient, and hospital services.


• Audit providers based on documentation verifying medical decision-making level selection for clinic office visits (evaluation and management CPT).


• Audit complex surgical cases. 


• Document audit findings.


• Serves in an advisory and educator role for Coding Specialists, Patient Financial Services (PFS), Providers and all clinical staff.


• Manage Revo Coding Education Email and Education WQs.


• Perform extensive research for coding questions that arise from Providers, Coding Specialists, PFS, and Coding Leadership.


• Communicate yearly coding updates per CMS and AMA.


• Communicate coding guideline updates.


• Communicate payer updates, payer policy requirements/changes, and documentation issues when discovered.


• Annual internal coding policy reviews.


• Create workflows and processes as needed/assigned.


• Assists Coding Specialists in writing appropriate coding queries and appeal letters. 


• Support PFS in researching in coding denials.  


• Develop curriculum and materials for training programs.


• Participate in and/or organize scheduled coder meetings.


• Lead training sessions.


• Onboard new providers on documentation requirements when requested.


• Code assigned providers based upon department need. 


• Attend continuing education classes to maintain coding proficiency and certification requirements. 


• Any and all other duties as assigned.

Education and Experience Requirements:

• High School diploma/GED or equivalent


• CPMA Certification (Certified Professional Medical Auditor) required or obtained within 6 months of hire. 


• Coding Certification (CPC, CCS, CCS-P, RHIT or RHIA) and/or a graduate of a Coding Program with certificate/diploma of completion is strongly preferred.


• Minimum of 3 years’ medical coding experience or in related medical field preferred.


• Advanced knowledge of ICD-10-CM, CPT, HCPCS and payer specific guidelines.


• Advanced understanding of medical terminology, body system/anatomy, physiology, and concepts of disease processes.

Benefits & Compensation: 

• Actual starting pay will vary based on education, skills, and experience.


• We offer a comprehensive Medical, Dental & Vision Plan, Maternity Bundle, 401K with Profit Sharing, Tuition Reimbursement, Gym & Car Rental Discounts - to learn more click here. 

Essential Requirements:

Ability to:

• Comply with company policies, procedures, practices and business ethics guidelines.


• Complete job required training.


• Comply with all applicable laws and regulations, (e.g. HIPAA, Stark, OSHA, employment laws, etc.)


• Demonstrate prompt and reliable attendance


• Work remotely or in the clinic, office or surgery center during business hours 


• Travel independently throughout the clinic, office or surgery center (which may include movement from floor to floor); frequent bending, lifting, standing, stooping or sitting for long periods of time may be required


• Work at an efficient and productive pace, handle interruptions appropriately and meet deadlines


• Communicate and interact in a respectful and professional manner


• Prioritize workload while being flexible to meet the expectations of the daily operations


• Apply principles of logical thinking to define problems, establish facts, and draw valid conclusions


• Understand and execute a variety of instructions


• Effectively operate equipment and communicate on and operate the phone system


• Work independently with minimal supervision


• Travel to other work locations, if required

Performance Expectations – Revo Health’s Core Values:

• Integrity - Do the right thing and take responsibility for what you do and say


• Service - Consistently contribute to deliver an exceptional experience


• Quality - Act with high purpose, committed effort, and skillful execution to exceed expectations


• Innovation - Identify progressive solutions that improve service, teamwork, efficiency, and/or effectiveness


• Teamwork - Be a part of the whole; support each other positively

Environmental Conditions:

• Remote/Clinic/office/surgery center setting

Notes:

• Revo Health is an Equal Opportunity/Affirmative Action Employer and will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990 and the ADA Amendments Act of 2008.


• We participate in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here:  http://www.uscis.gov/e-verify/employees


• This position description will be reviewed periodically as duties and responsibilities change with business necessity. Essential and Additional Job Functions are subject to modification.