HCC Physician Coding Auditor

Thank you for considering a career at Ensemble Health Partners!

Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.

Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference

The Opportunity:

CAREER OPPORTUNITY OFFERING:

• Bonus Incentives

• Paid Certifications

• Tuition Reimbursement

• Comprehensive Benefits

• Career Advancement

• This position pays between $51,700 – $99,000 based on experience 

­­­­The HCC Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards.

Job Responsibilities:

• Quality Review - Monitors and audits professional fee risk adjustment accounts across all contracted clients. Performs annual performance, randomized and quality assurance reviews to assess comprehension of training efforts.

• Educating - Assesses the educational needs of coding staff and providers contracted/employed and outlined in the client SOW (included Provider Education verbiage) and develops programs or research educational resources to meet those needs. Creates and delivers presentations develops learning material, including recordings, PowerPoints, Pocket Cards, Quick Reference Guides, handbook and other educational materials

• Edits/Denials/Coding - Assists with edits, denials, and appeals. Assists with coding and working holds on an as needed basis

• Training - Assists with training providers, client leadership, in addition to, new and existing staff. Develops all training materials and coding aids for both formal training and use by coders in daily work. Identifies coders to be cross-trained and suggests areas for training improvement. Assists in the implementation and administration of effective systems, processes, and procedures

• Coordinating - Coordinates the presentation of ongoing professional seminars and materials via audio-conferences, webinars, and other publications. Maintains education records on all staff to include attendance records for all coding related educational activities

• Resource - Serves as a technical resource for all involved personnel; ensures that information is accurate and current, meeting professional coding standards. Performs miscellaneous job-related duties as assigned

• Reporting - Provides audit findings reports to coding management, individual coders and leadership as needed/requested along with providers contracted/ employed and outlined in the client SOW (Included Provider verbiage). Assists with the creation of various documents and reports as requested. Immediately provides reports related to compliance risks when requested

Experience We Love:

• 5+ years of coding experience.

• 3+ years of auditing experience.

• Proficiency in multiple EMR’s, encoders, and the Microsoft Office suite.

• Educated in HIPAA regulations; must maintain strict confidentiality of patient and client information.

• Consistently achieves quality and productivity standards.

• Ability to organize and complete work in a timely manner.

• Ability to read, write and effectively communicate in English.

• Ability to understand medical/surgical terminology.

• Above average written and verbal communication skills.

• Position may require 20-40% travel to client sites.

Minimum Education:

•   High School diploma or GED

Required Certifications:

Candidates must have and keep current at least one of the following professional certifications (CRC Preferred):

• CPC (Certified Professional Coder)

• CRC (Certified Risk Adjustment Coder)

• CCS-P (Certified Coding Specialist-Phys Based)

• CCS (Certified Coding Specialist)

• RAC (Risk Adjustment Coding)

• CMPA (Certified Professional Medical Auditor)

#LI-HB1

#LI-REMOTE

Join an award-winning company

Three-time winner of “Best in KLAS” 2020-2022

2022 Top Workplaces Healthcare Industry Award

2022 Top Workplaces USA Award

2022 Top Workplaces Culture Excellence Awards

• Innovation

• Work-Life Flexibility

• Leadership

• Purpose + Values

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:

• Associate Benefits –  We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs. 
• Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.  
• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement. 
• Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company. 

Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws.  Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.

Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact TA@ensemblehp.com.

This posting addresses state specific requirements to provide pay transparency.  Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position.  A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.

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