City/State
Norfolk, VAOverview
Work Shift
First (Days) (United States of America)Sentara is hiring a Compliance Coding Auditor-Remote
This is a full time ( 40 hour per week), day shift position for Sentara Consolidated Medical Group. This is a Remote position. Eligible candidates must have residency in one of the following states:
--> Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington State, West Virginia, Wyoming
The Compliance Coding Auditor performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits.
The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year.
All queries arising from the audit process are managed by the Compliance Auditor. Follows audit plan, completing numerous audits and providing follow-up to coders, management, and physicians. Looks for new problem areas, trends, etc., and advises Manager of Audit and Coding Compliance. Works with leadership regarding scheduling of internal and external audits.
Required:
Associates degree required or 2 years of related experience in lieu of education, plus 4 years of related experience.
Diversity and Inclusion at Sentara
Our vision is that everyone brings the strengths that come with diversity to work with them every day. When we are achieving our vision, we have team members that feel they belong and can be their authentic selves, and our workforce is reflective of the communities we serve.
We are realizing this vision through our Diversity and Inclusion strategy, which has three pillars: A diverse and talented workforce, an inclusive and supportive workplace, and outreach and engagement with our community. We have made remarkable strides in these areas over the past several years and, as our world continues to evolve, we know our work is never done.
Our strategies focus on bothstructural inclusion, which looks at our organizational structures, processes, and practices; as well asbehavioral inclusion, which evaluates our mindsets, skillsets, and relationships. Together, these strategies are moving our organization forward in an environment that fosters a culture of mutual respect and belonging for all.
Please visit the link below to learn more about Sentara's commitment to diversity and inclusion:
SentaraOverview
For more than a decade, Modern Healthcare magazine has ranked Sentara Health as one of the nation's top integrated healthcare systems. That's because we are dedicated to growth, innovation, and patient safety at more than 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals.
Sentara Benefits
As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers. We offer a variety of amenities to our employees, including, but not limited to:
Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within avibrant, creative, and highly productive workplace. For information about our employee benefits, please visit:
Join our team!We are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, and growth!
Please Note:The yearly Flu Vaccination is required for employment.
Sentara Health offers employees comprehensive health care and retirement
benefits designed with you in mind. Our benefits packages are designed to change with you by meeting your needs now and anticipating what comes next. You have a variety of options for medical. dental, and vision insurance, life insurance, disability and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave. Team Members have the opportunity to earn an annual flat amount bonus payment if established system and employee eligibility criteria is met.
Eligible candidates must have residency in one of the following states:
--> Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington State, West Virginia, Wyoming
For applicants within Washington State, the following hiring range will be applied:
$29.23- $40.35 per hour.
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Job Summary
Performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year. All queries arising from the audit process are managed by the Compliance Auditor. Follows audit plan, completing numerous audits and providing follow-up to coders, management, and physicians. Looks for new problem areas, trends, etc., and advises Manager of Audit and Coding Compliance. Works with leadership regarding scheduling of internal and external audits.Qualifications:
ALD - Associate's Level DegreeCertified Coding Specialist (CCS) - Certification - American Health Information Management Association (AHIMA), Certified Coding Specialist (CCS) - Certification - American Health Information Management Association (AHIMA), Certified Medical Assistant (CMA) - Certification - American Association of Medical Assistants (AAMA), Certified Professional Coder (CPC) - Certification - American Academy of Professional Coders (AAPC), Licensed Practical Nurse (LPN) - Nursing License - Other/National, Licensed Practical Nurse (LPN) Single State - Nursing License - Alabama, Licensed Practical Nurse (LPN) Single State - Nursing License - Arizona, Licensed Practical Nurse (LPN) Single State - Nursing License - Arkansas, Licensed Practical Nurse (LPN) Single State - Nursing License - Colorado, Licensed Practical Nurse (LPN) Single State - Nursing License - Delaware, Licensed Practical Nurse (LPN) Single State - Nursing License - Florida, Licensed Practical Nurse (LPN) Single State - Nursing License - Idaho, Licensed Practical Nurse (LPN) Single State - Nursing License - Indiana, Licensed Practical Nurse (LPN) Single State - Nursing License - Iowa, Licensed Practical Nurse (LPN) Single State - Nursing License - Kansas, Licensed Practical Nurse (LPN) Single State - Nursing License - Kentucky, Licensed Practical Nurse (LPN) Single State - Nursing License - Louisiana, Licensed Practical Nurse (LPN) Single State - Nursing License - Maine, Licensed Practical Nurse (LPN) Single State - Nursing License - Maryland, Licensed Practical Nurse (LPN) Single State - Nursing License - Mississippi, Licensed Practical Nurse (LPN) Single State - Nursing License - Missouri, Licensed Practical Nurse (LPN) Single State - Nursing License - Montana, Licensed Practical Nurse (LPN) Single State - Nursing License - Nebraska, Licensed Practical Nurse (LPN) Single State - Nursing License - New Hampshire, Licensed Practical Nurse (LPN) Single State - Nursing License - New Jersey {+ 48 more}Acute Care, CodingSkills
Communication, Complex Problem Solving, Critical Thinking, Technology/ComputerSentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.
In support of our mission "to improve health every day," this is a tobacco-free environment.