Coding & Audit Specialist- Full time, Days, REMOTE
About The Position
The Professional Coding & Audit Specialist I performs audits of Centra Medical Group (CMG) provider documentation and coding of professional evaluation & management (E/M) services to include E/M, International Statistical Classification of Diseases and Related Health Problems, tenth version- Clinical Modification (ICD-10-CM), Current Procedural Terminology (CPT) codes and modifiers to determine accuracy based on current coding guidelines, regulatory requirements and billing rules related to coding. This position provides education and training to CMG providers and staff related to professional coding and documentation under the direction of the Manager Professional Coding & Audit and the Professional Coding and Audit Specialist.
Requirements
- A career studies certificate in Medical Coding and eligible to sit for AAPC Certified Professional Coder credential
- Completed coursework in Anatomy & Physiology, Medical Terminology, ICD-10 and CPT coding, Healthcare Compliance & Billing
- Obtain coding credential through AAPC within 1 year of hire date and maintain credential.
- Communicates effectively with great listening skills.
- Must be able to learn and utilize custom systems and applications.
Nice To Haves
- Strong PC skills, including Microsoft Office products, specifically Word, Excel, and PowerPoint
Responsibilities
- Completes annual initial coding reviews as assigned by the Manager of Professional Coding and Audit for Centra Medical Group (CMG) with a focus on Evaluation and Management
- Prepares individual provider Audit Summary reports based on review and shares findings per Centra’s CMG Coding Audit Plan Policy
- Maintains a working knowledge and utilizes the current documentation guidelines for E/M services, ICD-10-CM, CPT, Healthcare Common Procedure Coding System (HCPCS) coding guidelines to apply best practices, conduct accurate audits and deliver feedback.
- Maintains a working knowledge and utilizes Centers for Medicare & Medicaid Services (CMS), Medicare Administrative Contractor, Commercial payer, and other coding references (AMA, AAPC, CPT Assistant, etc.) guidelines related to coding to apply best practices, conduct accurate audits, and deliver feedback and education.
- Research authoritative coding guidance related to complicated coding questions, new codes and/or new services to build own knowledge.
- Reports coding concerns to the Professional Coding and Audit Manager and assists as needed in resolving issues.
- Assists with the development of education, training, and resources to be used for educating providers and staff to promote accurate coding.
- Maintains strict confidentiality of all information including patient data, Healthcare information, financial/operational and employee/human resources.
- Performs other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
Number of Employees
5,001-10,000 employees
