Coding Audit Response Specialist - Ambulatory

Why This Role Matters:

The Ambulatory Coding Audit Response Specialist will contribute to Novant Health’s commitment to delivering the most remarkable patient experience, in every dimension, every time by supporting revenue cycle services across the enterprise. The ability to drive accuracy and adherence to coding guidelines, governmental and private Third-Party rules, and regulations is key for this role. 

What You Will Do:

• Schedule: Monday – Friday, daytime hours.
• The Coding Audit Response Specialist will proactively manage (including corresponding communications and escalation paths) significant issues in coding.
• Coordinate with Revenue Cycle Services (RCS) and other departments to resolve denials.
• Audits denied claims to ensure accurate billing and identify trends.
• Locate and pull medical records for claims corrections, claim clarification, and billing inquiries within assigned coding ladder.
• Write appeal letters to commercial payers for applicable accounts to support coding.
• Meet productivity standards and fulfill requirements of accuracy established by Novant Health Corporate Compliance for coding policy.
• Additional duties as assigned.

What You Will Need

Required:

• CPC, CCS-P, RHIA, or RHIT licensure.
• High School Diploma or GED.
• 5+ years of coding experience.
• 3+ years insurance follow-up experience.
• Extensive knowledge of ICD-9-CM (ICD-10-CM), CPT and HCPCS coding principles and guidelines.
• Extensive knowledge of reimbursement systems. Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing.
• Medical Terminology, advanced level; Anatomy and Physiology, advanced level with laboratory experience; Advanced level coding courses ICD-9-CM and CPT-4.
• Excellent analytical skills. Excellent verbal and written communication skills; Must be detail-oriented and analytical in nature.
• Must be able to work during times of unusual volume and of unusual need as workload demands.

Preferred:

• Epic experience.
• Extensive knowledge of various payor types and their requirements.
• Computer skills in databases, data entry experience with 3M Encoder software. PC word processing and spreadsheet skills.

What’s In It for You:

• Comprehensive benefits include medical, dental, vision, and life insurance.
• Retirement fund with matching contributions.
• Tuition assistance for qualifying team members.
• Employee assistance programs and discounts. 
• Company paid coding recertification dues.