The rewards at Healogics are immense, starting with the important work we do to change patients’ lives. We also understand that meaningful work is hard work, and we are committed to supporting and compensating our employees for the tremendous service they provide.
 

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Healogics is the largest provider of advanced wound care services in the United States, treating more than 300,000 chronic wound patients annually across over 600 sites. With an aging society, obesity and diabetes on the rise, and an uptick in surgical procedures, the number of patients with non-healing wounds that would benefit from expert care is dramatically increasing. As a result, the company is working to provide our differentiated, quality outcomes to as many patients that would benefit through our out-patient clinic partnerships.

The Compliance Coding Auditor is responsible for helping with the Compliance Department’s Auditing activities, including ensuring appropriate coding by providers and internal and external coders, as well as providing coding education, as required. The Compliance Coding Auditor audits medical and billing records for compliance with federal and state health care program and commercial payor coding and billing regulations and guidelines regarding the correct application of ICD-10, CPT, HCPCS Level II and modifiers. This position can be remote, based anywhere in the United States, but if remote then some minor travel will be required.

All Healogics employees must perform their job responsibilities according to all Healogics policies, Hospital policies, as well as to accrediting organizations, federal and state regulation, and to the Centers for Medicare and Medicaid Services (CMS) guidelines, as applicable..Essential Functions/Responsibilities:  Conducts audits of medical records, superbills, and other documentation to identify under coded, up coded, missing, or otherwise inappropriate physician E&M and Procedure CPT services and diagnosis codes.Identifies coding error trends and patterns and potential compliance concerns.Conducts additional coding and billing audits and reviews as assigned.Follows appropriate federal and state health care program and commercial payor billing and coding requirements, guidelines, and best practices.Maintains current coding certification and knowledge of relevant changes to federal and state health care program and commercial payor billing and coding requirements, guidelines, and best practices for physician coding and diagnoses.Identifies areas for provider and coder education, and as assigned, provides relevant coding and billing education to providers and internal and external coders.Prepares audit reports as necessary.Responds to internal inquiries regarding best coding and billing practices and regulations. Ensures strict confidentiality of medical and financial records. Reports to Manager Compliance Coding & Auditing, Director of Compliance Audits/Senior Director of Compliance AuditPerforms miscellaneous job-related duties as assigned.

Required Education, Experience and Credentials:

High-School Diploma

Minimum of three (3) years of experience auditing physician coding and diagnoses, or five (5) years of experience doing physician-related coding. Experience with Wound Care procedure codes, Hyperbaric Oxygen Therapy codes, and Evaluation & Management codes is preferred.

CPC certification required.

CPMA certification preferred.

CHC or other compliance certification preferred.

Required Knowledge, Skills and Abilities:

Proficiency in Microsoft Office Suite (Outlook, Teams, Word, Excel, PowerPoint) required.

Familiarity with coding and billing software strongly preferred.

Must have a high degree of ethics and integrity.

Ability to work in fast-paced environment and to work on multiple projects at the same time

Ability to work with others and in a team environment

Demonstrated history of high attention to detail. 

Self-starter with excellent time-management and organizational skills.

This range is an estimate, based on potential employee qualifications: education, experience, geography as well as operational needs and other considerations permitted by law. 

If you are a current employee, to submit a job application, you need to apply as an internal candidate in Workday via the “Jobs Hub”.