Monogram Health

Job Details

Description

Position: Senior Coding Auditor

The Monogram Senior Coding Auditor will be responsible for auditing our APP/MDs and Certified Coding teams monthly. Audit will include confirming all diagnosis codes and procedure codes have supporting documentation and are used correctly within the encounter. Senior Coding Auditor will be responsible for delivering results in a timely manner to all APP/MDs and Certified Coding teams monthly. Performs medical chart audits on a retrospective basis to identify, monitor and document claims and encounter coding information as it relates to complete documentation. Performs medical chart quality audits to ensure clinicians have accurate clinical documentation to support ICD-10 codes and are adhering to CMS Risk Adjustment guidelines. Educates clinicians and coders on specific coding issues found in their charts and keeps them abreast of coding and documentation guidelines.

Roles and Responsibilities

• Maintains 95% coding accuracy rate
• Maintains production goals
• Experience working remotely with proven ability to prioritize tasks, meet goals and deadlines
• Performs accurate and timely audits (CPT, ICD-10, HCPCS, modifiers).
• Demonstrate advanced knowledge of medical terminology, anatomy, and physiology
• Provides timely correspondence with providers regarding clinical documentation opportunities and queries.
• Identifies trends through data analysis or chart review, reviewing existing policy for accuracy and developing new policies and recommends solutions to meet objectives.
• Keeps abreast of mandated regulatory, documentation and coding guidelines to documentation, including demonstrated proficiency with all areas of CPT, ICD-10 and HCPCS coding. E/M code assignment, auditing, and education.
• Performs quality audits, education, and training for coding team.
• Works closely with leadership to create coding tools for coding team and providers.
• Provides training and onboarding for new hires.
• Performs other duties as required or assigned

Position Requirements

• This position is a remote position.
• CPC, CRC, CCS, or CCS-P credentials, required.
• CPMA credential, preferred not required.
• 3+ years’ experience in Certified Coder role
• 3+ years’ experience in HCC coding
• Experience billing is a plus.
• Experience coding telehealth coding is a plus
• Experience in Nephrology coding is a plus
• Experience with medical billing is a plus.
• Experience coaching and training peers is a plus.
• Experience working with Athena is a plus.
• Must have proficiency using a PC in a Windows environment, including Microsoft Word, Excel, Power Point and Electronic Medical Record.
• Experience communicating & working closely with Physicians.
• Experience in Medicare programs and regulations including fraud and abuse and Risk Adjustment
• Familiar with STARs performance measures and metrics.

Benefits

• Opportunity to work in a dynamic, fast-paced, and innovative value-based provider organization that is transforming the delivery of kidney care.
• Competitive salary and opportunity to participate in the company’s bonus program
• Comprehensive medical, dental, vision and life insurance
• Flexible paid leave and vacation policy
• 401(k) plan with matching contributions

About Monogram Health

Monogram Health is a next-generation, value-based chronic condition risk provider serving patients living with chronic kidney and end-stage renal disease and their related metabolic disorders. Monogram seeks to fill systemic gaps and transform the way nephrology, primary care and chronic condition treatment are delivered. Monogram’s innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs across the healthcare continuum. By focusing on increasing access to evidence-based care pathways and addressing social determinants of health, Monogram has emerged as an industry leader in championing greater health equity and improving health outcomes for individuals with chronic kidney and end-stage renal disease.

At Monogram Health we believe in fostering an inclusive environment in which employees feel encouraged to share their unique perspectives, leverage their strengths, and act authentically. We know that diverse teams are strong teams, and welcome those from all backgrounds and varying experiences.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.