Auditor, Professional Fee Coding

Shift: Day
Schedule: Full - Time Regular

Ardent Health Services invests in people, technology, facilities and communities, producing high-quality care and extraordinary results. Based in Nashville, Tennessee, Ardent’s subsidiaries own and operate 30 hospitals in six states with more than 25,000 employees including 1,150 employed providers. Ardent facilities exceed national averages in Overall Hospital Quality Star Rating as ranked by the Centers for Medicare & Medicaid Services; 89 percent of its hospitals received a three-star rating or above in comparison with 73 percent of all hospitals ranked. Five of the company's hospitals were recognized by Modern Healthcare as "Best Places to Work" in 2018 - the eleventh consecutive year an Ardent facility made this list. Ardent's corporate office was named "Top Work Places" for Nashville based companies in 2017 and 2018.

We have an exciting opportunity to join our team as an Auditor, Professional Fee Coding.

This exciting new position is a work from home opportunity. There may be some travel associated with this position.    

PRIMARY DUTIES AND RESPONSIBILITIES 

  • Use audit tools, authoritative references, CMS and CPT guidelines, bell curves, etc. to analyze for trends
  • Audit providers and coders and provide education and feedback individually or in a group setting.
  • Adhere to policies, procedures and regulations to ensure compliance.
  • The following are some, but not all-inclusive, of the responsibilities of the auditing function:
    • Audit provider E&M levels, surgical procedures and diagnoses using an auditing tool.
    • Audit revenue cycle processes (e.g. provider build, claim set up, denials, templates)
    • Adheres to provider auditing schedules and adheres to audit production standards set by the Director.
    • Maintains provider scoring results.
    • Provides standard documentation on education feedback to providers in a timely manner. 
    • Ability to identify process and/or documentation improvements
    • Ability to perform a trend analysis of provider's bell curves and pull reports accordingly.
    • Ability to work independently and use critical thinking skills.
    • Ability to provide education using standardized educational sheets to providers.
  • Ability to multi-task and work in a fast paced environment.
  • Flexibility to audit other markets as needed.
  • Ability to communicate effectively via email correspondence, web-ex meetings and/or face to face.
  • Successfully completes educational courses assigned by the Manager or Director.
  • Participates in quarterly onsite team meetings.

QUALIFICATIONS
     
Experience:

  • Experience with E&M /Procedure/Surgery Auditing/Critical Care/Specialty Specific/Skewed Productivity Curves
  • Minimum of 1 year of high volume auditing experience
  • Minimum of 3 years of professional coding for outpatient (facility and office) and inpatient and hospital surgical procedures
  • Minimum of 1 year of revenue cycle operations (provider build, claim set-up, billing, denials, etc.)

Licensure / Certification:

  • CPC (Certified Professional Coder) or equivalent certification required
  • Desired:  CRCR (Certified Revenue Cycle Representative)
  • Desired: Auditing certification (e.g. CPMA-Certified Professional Medical Auditor or CDEO-Certified Documentation Expert Outpatient)

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.