Hybrid Medical Coding Auditor na The Harris Center for Mental Health and IDD

Are you ready to make a real difference in people's lives? Join the Harris Center for Mental Health and IDD as a Medical Coding Auditor. Under the direction of the Compliance Manager, the Medical Coding Auditor conducts medical record audits to ensure that documentation meets required standards and regulations. Maintains up-to-date information on all the standards set by JCAHO, Medicare, Medicaid, and other entities relating to medical records. Reviews medical records for coding accuracy and completeness. Prepares audit reports that highlight deficiencies and suggest solutions.

Your Role in Action

• Analyzes medical records and identifies documentation deficiencies.
• Reviews and verifies documentation supports diagnoses, procedures and treatment results.
• Identifies diagnostic and procedural information.
• Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes.
• Ensures compliance with medical coding policies and guidelines; understands the application of each code set.
• Maintains current knowledge regarding coding and diagnostic procedures; follows coding.
• Works towards compliance in all aspects of coding, participates in compliance activities as requested, and conducts/participates in provider coding reviews and education, as requested.
• Serves as resource, subject matter expert, and consultant to other coding staff.
• Identifies discrepancies, potential quality of care, and billing issues.
• Researches, analyzes, recommends, and facilitates plan of action to correct discrepancies and prevent future coding errors.
• Maintains a high-level of integrity and confidentiality of medical information.
• Provides coding feedback and education to clinical team as needed.
• Answers questions, advises, and trains providers and staff on medical coding.
• Investigates coding issues and makes recommendations for correction of the issue.
• Responsible for reviewing and making payment determinations on provider medical claims.
• Uses Correct Coding Initiatives (CCI) and National Correct Coding Initiatives (NCCI) as a guide to uphold the Harris Center Policies and Procedure.
• Reviews medical records and documentation of claims to provide rationale for upholding or overturning denials.
• Has a strong understanding of physiology, medical terms and anatomy.
• Assigns CPT, HCPCS, ICD-10-CM, and DRG codes
• Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines.
• Researches and analyzes data needs for reimbursement

What qualifications you will need:

Education:

• Associate’s degree or equivalent.
• Bachelor of Science, preferred.

Experience:

• At least three (3) years work experience as a Medical Coder.
• At least two (2) years work experience in Mental Health Medical coding environment.

Other Key Qualifications

• Certification in Medical Coding.
• Coding Certification from APPC or AHIMA, preferred.

Knowledge, Skills & Abilities:

• State and Federal regulations related to healthcare services.
• Texas Administrative Code; Performance Contract
• Medical Billing/Coding Guidelines and Code Sets
• Knowledge of general accounting principles, revenue cycle processes, medical insurance, and associated regulations
• High degree of accuracy and attention to detail
• Ability to manage multiple tasks/projects, and deadlines simultaneously and to identify and resolve exceptions and to interpret data; proficient in data entry.
• Customer service orientation and negotiation skills, including the ability to interface with third party payers.
• Excellent communication skills, both verbal and written.
• Proficient computer skills, including Microsoft Office applications.
• Proficient in using Electronic Health Records.

About us:

The Harris Center is the state-designated Local Mental Health Authority and Local Intellectual and Developmental Disability (IDD) Authority serving Harris County, Texas.  As the largest behavioral and developmental disability care center in Texas, The Harris Center provides care to over 90,000 people and has an annual budget of over $300 million.

As part of its mission to transform the lives of people with behavioral health and IDD needs in the third largest county in the United States, The Harris Center provides a full continuum of services at 80 different sites across Harris County. In addition, services are provided in more than 40 different languages as well as sign language in order to better serve what is one of the largest communities in the nation.

By utilizing the unique expertise of its more than 2,500 employees, The Harris Center is committed to meeting the behavioral health and IDD needs of Harris County residents and giving them hope to live to their fullest potential.

What else you should know:

This posting is associated with position #1318.

What we have to offer:

The Harris Center not only offers a competitive salary but also a suite of excellent benefits designed to enrich your life both professionally and personally. Imagine a future with a robust retirement plan complemented by our generous company matching – a testament to our investment in your long-term financial well-being. Experience the unique advantage of our prior service credit, accelerating your journey towards a more substantial Paid Time Off accrual, empowering you to enjoy well-deserved breaks.

Enjoy Cell Phone Discounts, exclusive entertainment deals through Tickets at Work, and a free Headspace subscription for mental wellness. Additionally, our Employee Assistance Program supports your overall well-being.

Take advantage of significant financial relief through student loan forgiveness as a valued member of The Harris Center team. As a qualifying entity, our employees are eligible for various student loan forgiveness programs, designed to alleviate the financial burdens associated with higher education.

Contributes to suicide care and prevention by embracing our values and applying a trauma-informed approach rooted in safety, trust, choice, collaboration, and empowerment.