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Senior Coding Auditor (CCS cert) - Remote
Northwell Health • Remote • Posted 14 days ago
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Remote • Full-time • $66,220-$108,180/yr • Senior Level
Job Highlights
Using AI ⚡ to summarize the original job post
The Senior Coding Auditor at Northwell Health performs complex coding audits, drafts findings, and advises with organization leadership to provide education on regulations and mitigate compliance risk. This role involves reviewing data such as claims detail and medical record documentation to determine compliance with coding and documentation requirements, drafting reports on audit findings, and acting as an internal expert on coding issues to ensure compliance with state and federal regulations.
Responsibilities
- Reviews data, such as claims detail, coding and medical record documentation to determine compliance with appropriate coding and documentation requirements.
- Drafts reports detailing coding audit findings.
- Assists with billing/documentation and regulatory risk assessments.
- Acts as the internal expert on coding issues to ensure compliance with state and federal regulations.
- Research, interpret and communicate federal and state laws and guidelines pertaining to Medicare and NYS Medicaid.
- Completes thorough reviews of governmental coding audits determining potential non-compliance and future compliance risk.
- Provides general compliance education and support to audit and facility staff involved in coding and billing; focused training based on results of compliance audits and self-assessments.
- Collaborates with Internal Audit, Faculty Practice and Research Compliance to minimize overlap in compliance activities.
- Operates under limited guidance and work assignments involve moderately complex to complex issues where the analysis of situations or data requires in-depth evaluation of variable factors.
- Performs related duties as required.
Qualifications
Required
- Bachelor's Degree or equivalent combination of education and related experience.
- Current Professional Coder Certification or Current Coding Professional Certification.
- 3-5 years of relevant experience.
About Northwell Health
Northwell Health is a leading healthcare provider in New York State, United States. It offers a wide range of services including primary and specialty care, hospital and emergency care, research, education, home care, rehabilitation, and mental health services. With 23 hospitals, over 750 outpatient facilities, and more than 13,600 affiliated physicians, Northwell Health serves millions of patients annually.
Full Job Description
**Req Number** 109921
Job Description
Performs complex coding audits, drafts findings and advises with organization leadership to provide education on regulations and mitigate compliance risk.
Job Responsibility
+ Reviews data, such as claims detail, coding and medical record documentation to determine compliance with appropriate coding and documentation requirements.
+ Drafts reports detailing coding audit findings.
+ Assists with billing/documentation and regulatory risk assessments.
+ Acts as the internal expert on coding issues to ensure compliance with state and federal regulations.
+ Research, interpret and communicate federal and state laws and guidelines pertaining to Medicare and NYS Medicaid.
+ Completes thorough reviews of governmental coding audits determining potential non-compliance and future compliance risk.
+ Provides general compliance education and support to audit and facility staff involved in coding and billing; focused training based on results of compliance audits and self-assessments.
+ Collaborates with Internal Audit, Faculty Practice and Research Compliance to minimize overlap in compliance activities.
+ Operates under limited guidance and work assignments involve moderately complex to complex issues where the analysis of situations or data requires in-depth evaluation of variable factors.
+ Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.
Job Qualification
+ Bachelor's Degree required, or equivalent combination of education and related experience.
+ Current Professional Coder Certification, or Current Coding Professional Certification required, plus specialized certifications as needed.
+ 3-5 years of relevant experience, required.
***Additional Salary Detail**
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).
The salary range for this position is $66,220-$108,180/year
It is Northwell Health's policy to provide equal employment opportunity and treat all applicants and employees equally regardless of their age, race, creed/religion, color, national origin, immigration status or citizenship status, sexual orientation, military or veteran status, sex/gender, gender identity, gender expression, disability, pregnancy, genetic information or genetic predisposition or carrier status, marital or familial status, partnership status, victim of domestic violence, sexual or other reproductive health decisions, or other characteristics protected by applicable law.
Job Description
Performs complex coding audits, drafts findings and advises with organization leadership to provide education on regulations and mitigate compliance risk.
Job Responsibility
+ Reviews data, such as claims detail, coding and medical record documentation to determine compliance with appropriate coding and documentation requirements.
+ Drafts reports detailing coding audit findings.
+ Assists with billing/documentation and regulatory risk assessments.
+ Acts as the internal expert on coding issues to ensure compliance with state and federal regulations.
+ Research, interpret and communicate federal and state laws and guidelines pertaining to Medicare and NYS Medicaid.
+ Completes thorough reviews of governmental coding audits determining potential non-compliance and future compliance risk.
+ Provides general compliance education and support to audit and facility staff involved in coding and billing; focused training based on results of compliance audits and self-assessments.
+ Collaborates with Internal Audit, Faculty Practice and Research Compliance to minimize overlap in compliance activities.
+ Operates under limited guidance and work assignments involve moderately complex to complex issues where the analysis of situations or data requires in-depth evaluation of variable factors.
+ Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.
Job Qualification
+ Bachelor's Degree required, or equivalent combination of education and related experience.
+ Current Professional Coder Certification, or Current Coding Professional Certification required, plus specialized certifications as needed.
+ 3-5 years of relevant experience, required.
***Additional Salary Detail**
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).
The salary range for this position is $66,220-$108,180/year
It is Northwell Health's policy to provide equal employment opportunity and treat all applicants and employees equally regardless of their age, race, creed/religion, color, national origin, immigration status or citizenship status, sexual orientation, military or veteran status, sex/gender, gender identity, gender expression, disability, pregnancy, genetic information or genetic predisposition or carrier status, marital or familial status, partnership status, victim of domestic violence, sexual or other reproductive health decisions, or other characteristics protected by applicable law.
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