Banner Health · 7 hours ago
Facility HIMS Coding Auditor
United States
Full-time
Remote
Senior Level
$32.09/hr - $53.48/hr
7+ years expBanner Health is a nationally-recognized healthcare leader seeking a Facility HIMS Coding Auditor to join their team. This role is responsible for auditing and analyzing clinical documentation to ensure coding accuracy and compliance with guidelines while collaborating with various teams for education and process improvement.
Health CareInsuranceNon Profit
Responsibilities
Performs routine, focused and specialized audits on charts to ensure compliance with Coding Guidelines and alignment with clinical documentation. Provides feedback to staff on appropriateness and accuracy of coding and provides education, as needed, to correct any identified opportunities. Tracks individual and group staff performance to provide quality metrics to Leadership
Works with Banner stakeholders to evaluate and identity documentation opportunities. Provide feedback on audit results to include recommendations for coding and documentation. Establish, implement and maintain formalized review and audit processes
Work with external key stakeholders including but not limited to safety net vendors, government auditors, and revenue cycle vendor partners to evaluate audit findings and provide feedback utilizing authoritative references and Banner policies. Track results to collaborate on needed education or process improvement
Develop and maintain audit data used to monitor staff quality metrics for use in reporting, process improvement, education development, and quality improvement
Collaborates on the development, implementation, and maintenance of billing and audit system rules and collaborates on needed education. Identifies issues concurrently and communicates to appropriate leadership to facilitate timely action on education and/or edit creation
Develop audit-driven data to trend patterns and individual quality results by addressing items to include but not limited to: abstracting, principal diagnosis selection, principal procedure selection, missed query opportunities, etc. Uses data to participate in improvement of processes and programs through collaboration with leadership and education teams
This position is responsible for projects across multiple departments system-wide and requires interaction at all levels of staff and management. Requires work in the context of multiple commitments, priorities and conflicts
Functions in a fast-paced healthcare environment with a wide variety of healthcare programs, activities, and settings. This position is accountable for all resources within the areas of operational responsibility to ensure standards are exceeded for customer service, financial management and regulatory compliance. Internal customers include employees at all levels within the organization, including system leadership. External customers include vendors, providers and government entities
Works under limited supervision using specialized expertise in the subject matter. Works within a set of defined rules. Ability to address related and complex matters independently with regard to interpretation of coding guidelines, NCCI edits, and LCDs (Local Coverage Determinations) prior to referral to leader. Provides direction and feedback to all levels of coding staff and reinforces quality/education targets to assist with meeting quality metrics
Qualification
Required
3 years recent experience in Facility Inpatient coding (trauma, academic or high acuity facilities is preferred) and/or auditing and education experience (clearly reflected in your attached resume)
Bachelors Degree or equivalent experience
A Coding Assessment will be given after a successful interview to be completed within 48 hours
Must possess a current knowledge of business and/or healthcare as normally obtained through the completion of a bachelor's degree in business administration, healthcare administration or related field, or experience equivalent to same
Demonstrated proficiency in hospital coding as normally obtained through seven years of current and progressively responsible coding experience required
Requires a Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or Certified Coding Specialist-Physician (CCS-P) or Registered Health Information Technologist (RHIT) or Registered Health Information Administrator (RHIA), or other qualified coding certification in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC)
Must possess a thorough knowledge of ICD/DRG coding and/or CPT coding principles, as recommended by the American Health Information Management Association Coding Competencies
Requires an in-depth knowledge of medical terminology, anatomy, and physiology, plus a thorough understanding of the content of the clinical record and extensive knowledge of all coding conventions and reimbursement guidelines across service lines, LCD/NCDs and MAC/FIs
Extensive critical and analytical thinking skills required
Ability to organize workload to meet deadlines and maintain confidentiality
Excellent written and oral communication skills are required, as well as effective human relations skills for building and maintaining a working relationship with all leaves of staff, physicians, and senior leadership stakeholders
Able to identify areas of risk that require leader escalation
Must be able to function as part of a team, using effective interpersonal and instructional skills
Must have the ability to conduct educational needs analysis and to teach effectively to a wide range of comprehension levels
Must be proficient in the use of common office and presentation software and have an advanced knowledge and experience with computer healthcare applications and hardware
Must be able to work effectively and efficiently in a remote setting
Preferred
Prior audit experience, experience creating spreadsheets, pivot tables and normalizing data preferred
Previous Experience In Large, Multi-system Healthcare Organization Preferred
Additional related education and/or experience preferred
Company
Banner Health
Banner Health operates as a nonprofit health care system in the United States. The company offers hospital care, home care, hospice care,
10001+ employees
H1B Sponsorship
Banner Health 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 (85)
2024 (70)
2023 (35)
2022 (47)
2021 (51)
2020 (29)
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
Diane and Bruce Halle Foundation
2025-10-24Grant
Leadership Team
Andy Kramer Petersen
President & CEO Banner Health Foundation
Brian P. Kellar
Chief Executive Officer
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