Overview
**Must reside in the greater Phoenix / Scottsdale / NW Valley metro area.** Looking to be part of something more meaningful? At HonorHealth, you'll be part of a team, creating a multi-dimensional care experience for our patients. You'll have opportunities to make a difference. From our Ambassador Movement to our robust training and development programs, you can select where and how you want to make an impact.
HonorHealth offers a diverse benefits portfolio for our full-time and part-time team members designed to help you and your family live your best lives. Visit honorhealth.com/benefits to learn more.
Join us. Let's go beyond expectations and transform healthcare together.
HonorHealth is one of Arizona's largest nonprofit healthcare systems, serving a population of five million people in the greater Phoenix metropolitan area. The comprehensive network encompasses six acute-care hospitals, an extensive medical group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, community services and more. With nearly 15,000 team members, 3,700 affiliated providers and close to 2,000 volunteers dedicated to providing high quality care, HonorHealth strives to go beyond the expectations of a traditional healthcare system to improve the health and well-being of communities across Arizona. Learn more at HonorHealth.com.
Responsibilities
Job Summary
Under the direction of senior leadership, the Audit and Coding Consultant audits, develops educational materials, educates providers and coders regarding coding/documentation guidelines. Researches regulations on new codes and reviews opportunities for growth. Ensures accuracy and completeness of coding through a rigorous quality review of external and internal documentation of audit process ensuring compliance with federal and state regulations. Responsible for provider and coding training programs.
- Ensure appropriate methodology to include financial controls, identification of trends and unusual patterns, reimbursement deficiencies, and to improve processes. Confirm appropriate services are provided in accordance with examination protocol and medical billing. Work with vendor to ensure audit processes maintain appropriate controls, providing feedback to both vendor and physicians regarding results. Identify unusual examiner patterns based on trends identifiable to the vendor/provider or coder. Identify deficiencies in the reimbursement process and opportunities for appropriate reimbursement. Provide a detailed report listing the findings and any adjustments required to the invoices for all inappropriately invoiced services. Make recommendation for improvements in processes or policies and create/execute provider education for individuals and/or group sessions. Maintain audit results and ensure provider movement throughout the compliance audit plan. Analyze and confirm external results and as appropriate, which with senior leadership and compliance to create action plans.
- Research guidelines and regulations for proposed lines of business. Keep revenue cycle and physicians updated on new or changing regulations. Work with IT to ensure that codes are updated and build for new services include required data points.
- Performs other duties as assigned.
Qualifications
Education
Associate's Degree or 2 years' work related experience Required
Experience
3 years Revenue Cycle experience Required
3 years Professional Coding experience Required
Licenses and Certifications
Certified Professional Coder (CPC) Professional coding certification Required
Professional coding Auditor certification Required
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HonorHealth
Nov 06, 2024