Audit & Onboard Specialist - Museum District - Hybrid

Come lead with us at Houston Methodist Specialty Physician Group. At Houston Methodist, the Audit & Onboarding Specialist position is responsible for planning, coordinating and completing complex documentation, coding and billing reviews. This position serves as a liaison between the Centralized Business Office (CBO) and clinical departments and provides direction and guidance to coders and clinical providers. The Audit & Onboarding Specialist is also responsible for ensuring successful onboarding of physicians regarding compliance in clinical documentation and coding.

• Onboards new clinical practitioners, including but not limited to physicians, nurse practitioners, and physician assistants, to ensure they are documenting and coding appropriately for all services provided.
• Reviews coding accuracy and provides review results to the coding supervisor(s).
• Provides ongoing documentation, coding, and billing education to employees as needed.
• Collaborates with the CBO to communicate audit results. Delivers a list of exceptions needing corrective action.

• Education
  • High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.).
• Experience
  • Seven years of progressive multi-specialty professional coding experience
• Licenses and Certifications
  • Must have one of the following:
  • CPC - Certified Professional Coder (AAPC)
  • CPC-H - Certified Professional Coder - Hospital (AAPC)
  • CPC-I - Certified Professional Coder Instructor (AAPC)
  • CCS - Certified Coding Specialist (AHIMA)
  • CCS-P - Certified Coding Specialist Physician-based (AHIMA)
• Skills and Abilities
  • Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations.
  • Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security.
  • Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles.
  • Knowledge of ICD, CPT and HCPCS coding systems.
  • Knowledge of healthcare billing and PATH guidelines.
  • Computer skills including spreadsheet, word-processing, presentation, and compliance tracking software; ability to navigate healthcare regulatory websites.
  • Effective verbal and written communication skills; and effective presentation skills to a variety of audiences.
  • Demonstrates a positive, helpful and supportive attitude and demeanor.
  • Ability to handle confidential/sensitive information professionally.
  • Ability to analyze information and identify issues; exercise good judgment and envision outcomes when making decisions.
  • Ability to identify trends and report them clearly and concisely.
  • Ability to multi-task in a fast-paced environment, prioritize projects and maintain attention to detail.
  • Self-motivated and able to think critically and work independently.

• People Essential Functions
  • Onboards new clinical practitioners to ensure documentation and coding alignment for all services.
  • Reviews coding accuracy and provides results to the coding supervisor(s).
  • Provides ongoing documentation, coding, and billing education to employees as needed.
  • Collaborates with the CBO to communicate audit results and deliver a list of exceptions needing corrective action.
• Service Essential Functions
  • Provides quality assurance, direction and guidance to departments.
  • Demonstrates Houston Methodist Experience Service Standards and translates them into specific expectations to meet customer needs.
  • Ensures protection of private health information and adheres to HIPAA regulations.
• Quality/Safety Essential Functions
  • Designs, delivers, and assesses educational materials for physician/staff training.
  • Monitors provider progress to ensure adherence to regulations and policies.
  • Designs and completes annual documentation and coding review plans with action items.
• Finance Essential Functions
  • Ensures all charges are documented and billed appropriately in a timely manner.
  • Reviews physician coding trends and identifies opportunities for improved coding, documentation and/or charge capture.
  • Audits new provider documentation and coding to ensure timely charges and payments.
• Growth/Innovation Essential Functions
  • Maintains current knowledge of coding industry standards, policies, and procedures.
  • Assists in writing policies and procedures to address billing compliance and documentation issues.

• Work Attire
  • Business professional:
    Yes
• On-Call
  • Note that employees may be required to be on-call during emergencies;
    On Call:
    No
• Travel
  • Travel specifications may vary by department.
  • May require travel within the Houston Metropolitan area:
    Yes
  • May require travel outside Houston Metropolitan area:
    No

Houston Methodist is an Equal…