Laboratory Coding Auditor​/Educator

Overview

The Laboratory Coding Auditor/Educator assists with oversight of coding audits and delivers targeted education for the Laboratory Billing & Coding Representatives, Pathologists, and applicable departments. This role works closely with and supports Laboratory leadership to ensure regulatory and compliance requirements are met for appropriate code assignment, while serving as a senior coding resource for the department. The Auditor/Educator conducts billing workflow and charge integrity audits to ensure laboratory orders and charges accurately transmit to EPIC.

The Auditor/Educator adheres to all duties of the Laboratory Billing & Coding Representative.

• Must be able to perform essential job functions of Laboratory Billing & Coding Representative.
• Assists Laboratory Revenue Integrity & RCM Manager in managing audits and audit schedules.
• Provides coding audits to Laboratory Coding & Billing Representatives and Pathologists specific to CPT, HCPCS, modifier, and place of service coding.
• Provides education as needed, either one-on-one or group format to team members and Pathologists.
• Provides billing workflow and charge integrity audits to ensure laboratory orders and charges accurately transmit to EPIC.
• Compiles and tracks statistics related to the audit process.
• Serves as senior coding resource for department.
• Responsible for training new billing staff in laboratory coding and billing practices.
• Attend meetings as required with Pathologists, LIS, Revenue Cycle, and HIM on topics related to coding and auditing.
• Supports manager by interpreting and analyzing billing data to identify and monitor performance and established benchmarks for the department.
• Maintains knowledge of current and required coding regulations and assures team members are updated as regulations change.
• Trends coding-related denials, identifies root causes, and advises leadership on opportunities to resolve trends.
• Builds collaborative relationships with laboratory departments, pathologists, LIS, Revenue Cycle Systems, and other departments to support accurate system configuration.
• Tracks and trends all role functions for reporting purposes.
• Meet with Manager of Laboratory Revenue Integrity & RCM to review audits and attend meetings as required on topics related to coding and auditing education needs and follow up.
• Work with Laboratory Leadership to establish coding guidelines and assure coding team audits are completed timely.
• Report compliance or other concerns directly to Laboratory Leadership as needed or indicated.

Certifications:

Registered Health Information Technician (RHIT) - American Health Information Management Association(AHIMA);
Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC),

Education:

High school Diploma or G.E.D ,

Work Experience:

Coding

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Our nearly 17,000 team members and providers work together to support patient care across central and southeastern Illinois. We’ve grown to include eight, award-winning hospitals and a multispecialty provider group with more than 1,500 doctors and advanced practice providers. We’re developing the next generation of providers and healthcare professionals through Carle Illinois College of Medicine, the world’s first engineering-based medical school, and Methodist College.

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