Outpatient Complex Audit Specialist/Full Time/Remote

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Under the direction of the Outpatient Audit, Analytics & Technology Supervisor, in conjunction with OP Audit Analysts and Coordinators will utilize documentation and coding expertise to facilitate audits of the quality and completeness of medical record documentation for outpatient encounters, including but not limited to clinic visits, outpatient surgical procedures, telemedicine, and other ancillary services. Through concurrent, prospective and retrospective evaluation and assimilation of the medical record, the OP Audit - outpatient complex audit specialist will be responsible for utilizing knowledge of Local, State and Federal coding guidelines and regulations, NCCI Edits, ICD-10CM, CPT, Hierarchical Condition Categories (HCC), standards of compliance, and clinical knowledge to accurately abstract information from the electronic health record for compilation of an OP CDI Education database, which supports the Documentation & Coding Provider Education Program, data-driven resourcing, monthly provider performance scorecards, revenue cycle projects, KPI metric dashboards, and administrative decision making related to Revenue Cycle.

Education And Experience

• High school diploma or G.E.D. equivalent required.
• Minimum of two (2) years coding experience required.
• Additional specialty coding certification or 5-7 years coding experience required.
• Prior experience in a healthcare revenue cycle position required. Specialty coding experience preferred.
• One to two (1-2) years college or additional course work in Accounting, Business, Healthcare Administration or Medical Record Sciences preferred.
• Must have through knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems.
• Strong organizational and time management skills required to effectively prioritize work.
• Ability to communicate effectively with colleagues, supervisor, and manager.
• Ability to work independently.
• Ability to work remotely.
• Proficient in medical terminology.
• Proficient in ICD-10 CM, CPT, HCC and HCPCS coding.
• Able to recognize patterns and trends and escalate to supervisors to support root cause analysis.
• Able to assist other team members.

Additional Information

• Organization: Corporate Services
• Department: CDI - Education Support
• Shift: Day Job
• Union Code: Not Applicable

Additional Details

This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.

Overview

Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services – from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford’s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation’s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers .

Benefits

The health and overall well-being of our team members is our priority. That’s why we offer support in the various components of our team’s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.

Equal Employment Opportunity/Affirmative Action Employer

Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.

If you have questions about this posting, please contact [email protected]