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MaineGeneral Health

Coder II

Career Insights for Quality Assurance Auditor

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What they do

A Quality Assurance Auditor regularly evaluates the quality control systems in place and verifies compliance with quality and safety standards.

$56,123 / year median in Maine

-4% projected decline

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Job Description

Job Summary:

Assigns diagnosis and procedure codes to ensure quality documentation and accurate reimbursement for services provided. Assists with reconciling patient lists/census/discharge reports to track complete and accurate documentation/charges are obtained for each service rendered. Abstracts key non coding elements necessary for accurate billing (example: surgeon, surgical episode, discharge disposition) and manages worklists of incorrect claims and corrects to further support accurate billing. Reports back to providers and/or administrators regarding missing information. Reviews complex visit documentation from outpatient and/or ancillary areas to identify appropriate diagnostic and procedural codes (examples: ED, Cancer Center, Outpatient Surgery, Observation, Infusion). Uses coding guidelines and clinics to assign and sequence appropriate codes for 3-5 outpatient and/or ancillary patient areas in clinical information systems, including the assignment of appropriate modifiers as necessary. Queries practitioners as necessary to clarify. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.

Compensation Information:

$22.48 - $39.35 The hourly pay range shown represents the base pay range for this position. Individual pay is determined based on factors such as experience, qualifications, skills, and market considerations. In addition to base pay, eligible team members may earn additional compensation through shift, weekend, holiday, on-call, and other applicable differentials. We are proud to offer a competitive total rewards package designed to recognize our caregivers and support them in delivering exceptional care to the communities we serve.

Scheduled Weekly Hours:

40

Job Exempt:
No Benefits:

Supporting all aspects of our employees' wellness - physical, emotional and financial - is a critical component of being a great place to work. With the wide range of benefits and programs available, employees have the resources they need to be well at every stage of life and plan for the future.

Physical Wellness:

We offer quality health, dental, and vision benefits and wellness programs and resources to provide employees access to resources for a healthy lifestyle and help manage health care costs. Employees have access to industry-leading leave for new parents. A generous earned time plan is offered to all employees - We believe employees need and deserve time away from work to observe holidays, be with family, go on vacation, or simply take care of themselves.

Emotional Wellness:

When life gets challenging, employees have access to our Employee Assistance Program for employees and anyone in their household.

Financial Wellness:

Access the wages you've already earned before payday with Payactiv, giving you greater flexibility over your finances. Tuition Reimbursement is available to all employees to further develop skills and career. We offer eligible employees up to 2% of eligible pay in 403(b) company-matching contributions plus another 2% in the 401(a) retirement income plan. Three insurance plans are available to protect your family from the sudden loss of income in the event of your death, terminal illness or serious injury from accident. We offer both short-term and long-term disability insurance to replace a portion of your income if you become disabled and cannot work for a period of time.

Career Mobility:

Helping our employees develop their skills and grow their careers is critical to how we retain our talent and sustain our business. We do this by offering our teammates a variety of leadership-supported programs and learning and development resources for every stage of their professional development. We know that our employees are our most valuable resource - they're how we grow our business and care for our community. Equal Opportunity Employer M/F/Vet/Disability Assistive technologies are available. Application assistance for those requesting reasonable accommodation to the career site is available by contacting HR at (207) 861-3440 .

Benefits

  • Financial Aid/Assistance
  • Professional Development
  • 403(b) Tax-Sheltered Annuity Plans
  • 401(a) Plans