Job Summary: In a career as a Medical Coding Auditor, you join us in providing life-changing care to patients from across the region. In this role you will provide coding and compliance support to multi-specialty physicians, mid-level providers, support staff and administration.
Schedule: Full Time
Reviews and audits provider documentation (i.e., EMR, operative notes, etc.) coding submissions performed by the Medical Coding Group, including and resulting professional coding and billing from various departments and specialties within BTNRH, per the standards set forth in the Boys Town National Research Hospital (BTNRH) Coding Compliance Plan, reporting on the accuracy of procedure coding, E&M coding, ICD-9/ICD-10 coding and billing, to ensure compliance with legal regulations and procedural policies.
Through various auditing opportunities, identifies inaccurate coding and/or billing services; prepares reports of findings, and meets with coders, providers, and medical office staff to provide education and training on accurate coding practices and compliance issues.
Assists in training personnel in correct documentation processes and coding guidelines.
Applies knowledge of ICD-9-CM/ICD-10-CM inpatient and outpatient coding guidelines and CPT format, guidelines, and notes to locate the correct codes and sequence them correctly. Clarifies conflicting, ambiguous, or nonspecific information, querying and consulting the appropriate clinician to ensure sufficient documentation and accurate codes being billed for physician professional services.
Responsible for monitoring statistical data based on audit findings and concurrent reviews for trending purposes and summaries for Administration.
Recommends and implements quality control systems to ensure that clinical and charging workflows are efficient, effective, and in compliance with internal and external laws, policies, and standards. Ensures that operations comply with requirements for patient confidentiality and information security. Works with appropriate multidisciplinary team to rectify issues, ensuring efficient and accurate operations within the BTNRH revenue cycle and reports back to Administration as necessary.
Responsible for maintaining in depth and current knowledge of regulatory requirements as directed by agencies such as The Joint Commission, OIG and other regulatory agencies by conducting special studies and projects as assigned; researches and analyzes information: prepares statistical and narrative reports and documents as needed to ensure an appropriate audit trail is maintained at all times, making timely suggestions as necessary for internal coding and compliance policy and procedures.
High school diploma or equivalent.
Associate or bachelor's degree in business, healthcare or related field preferred.
Minimum of 5 years' experience in compliance, medical auditing, utilization review, coding or other related healthcare experience, required.
Additional coding credentials either from the American Health Information Management Association or the American Academy of Procedural Coders or eligible to take examination.
Must have extensive knowledge and understanding of ICD-9-CM/ICD-10CM, CPT-4, HCPCS Level II, Revenue Code assignments, coding. systems, medical terminology, abbreviations, anatomy & physiology and diseases.
Must possess the ability to communicate effectively with a wide variety of individuals, both orally and in writing.
Must have experience with software applications as they apply to the computerized patient record and billing system. Consideration will be given to persons with an equivalent combination of education and experience from which comparable knowledge can be acquired.
About Boys Town: Boys Town has been changing the way America cares for children and families since 1917. With over a century of service, our employees have helped us grow from a small boardinghouse in downtown Omaha, Nebraska, into one of the largest national child and family care organizations in the country. With the addition of Boys Town National Research Hospital in 1977, our services branched out into the health care and research fields, offering even more career opportunities to those looking to make a real difference.
Our employees are our #1 supporters when it comes to achieving Boys Town's mission, which is why we are proud of their commitment to making the world a better place for children, families, patients, and communities. Unique perks to Boys Town employees and their families include free visits to Boys Town physicians and free prescriptions under the Boys Town Medical Plan, tuition assistance, parenting resources from our experts and professional development opportunities within the organization, just to name a few. Working at Boys Town is more than just a job, it is a way of life.
Date Posted: January 11, 2021
Boys Town National Research Hospital is a tobacco free campus. This advertisement describes the general nature of work to be performed and does not include an exhaustive list of all duties, skills, or abilities required. Boys Town is an equal employment opportunity employer and participates in the E-Verify program. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status. To request a disability-related accommodation in the application process, contact us at 1-877-639-6003.
Internal Number: 16505
About Boys Town National Research Hospital
Since the opening of Boys Town National Research Hospital in 1977, the hospital has been internationally recognized as a leader in clinical and research programs focusing on childhood deafness, visual impairment and related communication disorders. We have developed national medical programs that are now instituted in hospitals and clinics across the country.
Today, the hospital offers a broad range of clinical services, including ear, nose and throat services at the Boys Town Ear, Nose and Throat Institute, general pediatric care with Boys Town Pediatrics, and orthopaedic, internal medicine, pediatric gastroenterology, allergy, asthma, pediatric pulmonology, behavioral health, audiological and ophthalmologic care.
The hospital has expanded to offer surgical and clinical services at two Omaha locations: 555 North 30th Street in Omaha and 14000 Hospital Road on the campus of Boys Town, Nebraska.
Boys Town National Research Hospital has assembled national leaders in research who are making important contributions in the areas of genetics, hearing, language, vision and speech disorders. Applying these findings with new technologies, distance learning and the exploration of ne...w research frontiers, the opportunities for new medical diagnoses, evaluation and treatment discoveries are endless.
Accredited by The Joint Commission, Boys Town National Research Hospital is dedicated to providing leading edge clinical care, pioneering translational research and improving the lives of children and their families through applied technology and educational outreach programs. The hospital annually serves more than 40,000 children and families from across the United States.