Job Description

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.

FT role requires supporting the coding department during core business hours, 7:30 AM - 5:00 PM in the Central Time Zone. This role is 100% remote.

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

Essential Job 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:

• 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 benefits package - to learn more click here.
• Employees working 30+ hours per week (60 hours per pay period) are eligible for our Medical (w/Maternity Bundle), Dental & Vision plans, as well as Tuition Reimbursement.
• All employees, regardless of hours, are eligible for 401(k) Profit Sharing, Employee Assistance Program, Lifetime Fitness Subsidy, Car Rental discounts, Home, Auto, & Pet insurance savings programs & more.

Working Conditions:

• Ability to sit for extended periods (up to 8 or more hours per day).
• Frequent use of hands and fingers for typing, writing, and handling documents.
• Occasional standing, walking, bending, or reaching within the office environment.
• Ability to lift and carry office supplies or files weighing up to 20 pounds.
• Visual acuity to read electronic and paper documents.
• Auditory ability to participate in phone or video calls clearly.
• Manual dexterity to operate standard office equipment (e.g., computer, phone, printer).

Essential Requirements:

Ability to:

• Comply with company policies, procedures, practices, and business ethics guidelines.
• Comply with all applicable laws and regulations, (e.g. HIPAA, Stark, OSHA, employment laws, etc.)
• Demonstrate prompt and reliable attendance.
• Work at an efficient and productive pace, handle interruptions appropriately, and meet deadlines. Prioritize workload effectively.
• Communicate respectfully and professionally in face-to-face, phone and email interactions. Apply principles of logical thinking to define problems, establish facts, and draw valid conclusions.

Notes:

• Revo/ i-Health is an Equal Opportunity Employer. We are committed to fostering an inclusive and accessible workplace. Reasonable accommodation may be provided to enable individuals with disabilities to perform essential job functions. Applicants or employees who wish to request an accommodation may do so by emailing HR@RevoHealth.com. For more information, please review the Know Your Rights notice from the U.S. Equal Employment Opportunity Commission.
• 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: https://www.e-verify.gov/employees/employee-rights-and-responsibilities
• Please note: This job description is intended to describe the general nature and level of work being performed by individuals assigned to this position. It is not an exhaustive list of all duties, responsibilities, and qualifications required. Revo/ i-Health reserves the right to modify job duties or descriptions at any time, with or without notice, in accordance with applicable laws.