HIM Documentation Auditor

Job Number 68215
Posted 1/21/2020
Account Northern Light Health Home Office
Department Health Information Management
Location |ME| Northern Light Health Home Office-43 Whiting Hill Rd., ME 04412
Schedule Regular Full-time
Shift Day
Hours 8:00-4:30
Job Details
Position Summary: Apply detailed knowledge of health information management, revenue cycle, reimbursement, data streams, and auditing principles while conducting documentation reviews to support billed services by NLH. Educate providers, nursing, and ancillary departments on documenation practices. Evaluate E/M bell curve date for NLH by specialty and provider for education on improvements.
Essential Functions:
  • Subject matter expert on documentation needed to support services billed by NLH for both facility and professional claims using CMS E/M Documentation Guidelines, the AMA's CPT & HCPCS guidelines, and payer specific reimbursement policies.
  • Analyze documentation, and develop corrective actions when warranted in response to third party audits on services billed
  • Educate providers, nursing, and ancillary departments on documentation deficiencies
  • Prepare financial and bell-curve report findings for distribution to NLH leadership
  • Analyze E/M bell curve data for review with providers
  • Conduct new provider orientation on documenation requirements for E/M services
  • Maintains and exhibits a current knowledge of profession and completes required continuing education.
  • Maintains a safe environment complying with NLH policies and procedures; reports and directly addresses environmental hazards and violations of patient safety policy and/or protocol when involved or observed.
  • May perform other duties upon request.
Education and Experience:
  • Associates Degree in HIM or healthcare related field of study (Non-Clinical) or 4 years of related experience required.
  • 5 years of experience with Documentation Review and Healthcare Reimbursement preferred.
  • RN (Clinical) or RHIT/CPC/COC/CIC/CCS/CCS-P (Non-Clinical)
Working Conditions:
Work involves lifting no more than 10 pounds at a time and occasionally lifting or carrying articles like files, ledgers, and small tools. Although a sedentary job is defined as one which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Travel as necessary for education with providers, nursing, coding, and ancillary department staff throughout the enterprise.

Equal Opportunity Employment
We are an equal opportunity, affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, disability status, gender, sexual orientation, ancestry, protected veteran status, national origin, genetic information or any other legally protected status.

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