Hartford HealthCare · 4 weeks ago
HIM Audit and Educ Specialist / HIM Clinical Document Mgmt
Farmington, CT
Full-time
Onsite
Senior Level
5+ years expHartford HealthCare is Connecticut's most comprehensive healthcare network, and they are seeking an Audit & Education Specialist to develop and implement an effective audit and education program for coding. The role involves supporting documentation practices, performing audits, and providing education and training to ensure compliance with regulatory and professional standards in healthcare revenue cycle practices.
Health CareHealth DiagnosticsHospitalOncologyPharmaceuticalRehabilitation
Responsibilities
Performs revenue opportunity assessment and executes the professional audit work plan which includes provider audit and education with QA. Compile and prepares complex reports for distribution to key leadership stakeholders
Analyzes audit results, creates material for education and performs education and training for providers and staff to ensure updates and quality assurance on coding
Creates and trains on documentation templates designed for specialty/client, e.g., medical reports, monitoring/analysis reports, continuous auditing tools, etc. to insure appropriate documentation is captured for services rendered
Researches literature from regulatory groups such as; HHS/OIG, Medicare, Medicaid, NGS, etc., professional and peer organizations' practices/policies/guidelines to keep organization current with regulatory requirements and accepted audit and education practices
Identify common documentation and coding issues and process improvement and effectively communicates via memos and other documentation to disseminate audit requirements
Identify process improvements to capture data for Medicare Risk Adjustment and help providers code to the level of specification
Builds relationships, programs, and processes alongside providers that will result in more accurate documentation and coding of diagnoses
Develops strategies to support knowledge transfer and testing to determine outcome and success of training
Provides individualized education to physicians and tracks performance over time
Demonstrate a face to face communication style and address issues as they arise
Qualification
Required
Medical Coding License required (CPC, CCS-P, CCS)
Minimum of five years' work experience with CPT, HCPCS and ICD-10 coding conventions required
Experience with interpreting Medicare, Medicaid and third-party billing and compliance regulations necessary
Experience with Claim Submission requirements required
Demonstrates experience analyzing data, review results and providing education to both clinical providers and coders in a productive manor
Exemplary communication skills; ability to navigate challenging conversations and provide effective provider training in large and small groups
Effectively able to influence providers to improve documentation
Demonstrates experience in project management and follow up required
Progressively responsible role with leadership
Experience with Word, Excel and PowerPoint required
Commitment to maintain complete confidentiality of patient health information
Will require on site auditing and training
Reliable transportation, insurance, and a valid driver's license
Must be able to excel in a fast paced business environment handling multiple priorities
Must be highly effective in both written and oral communication
Must be able to exercise appropriate judgment when making decisions
Preferred
Experience working with CMS, health insurers and medical providers strongly desired
Minimum of seven years' work experience with CPT, HCPCS, and ICD-10
CPMA not required but preferred
Baccalaureate degree not required but preferred
CRC not required but preferred (it is expected that candidates that are not CRC qualified will obtain the qualification within the first 4 - 6 months of their employment with Hartford Healthcare
Experience with the nuances of diagnosis coding and risk adjustment programs preferred
Experience working in an educational/ training role preferred
Knowledge of business systems, e.g., Epic preferred
Benefits
Competitive benefits program designed to ensure work/life balance
Company
Hartford HealthCare
Hartford HealthCare is a group of hospitals that offers complete healthcare services including cancer care, rehabilitation and pharmacy.
10001+ employees
H1B Sponsorship
Hartford HealthCare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (9)
2024 (2)
2023 (4)
2022 (6)
2021 (4)
2020 (8)
Funding
Current Stage
Late StageTotal Funding
$150MKey Investors
Connecticut Health and Educational Facilities Authority
2024-04-01Debt Financing· $150M
Leadership Team
Jeffrey Flaks
President & Chief Executive Officer
Bimal Patel
President and COO
Recent News
Hartford Business Journal
2025-12-18
Company data provided by crunchbase