EMR CODING AUDITOR

GALEN MEDICAL GROUP PC•Hixon, TN

2d•Onsite

About The Position

EMR Coding Auditor Summary/Objective: The EMR Coding Auditor (ECA) facilitates improvement in the overall quality, completeness and accuracy of medical record documentation. The individual will perform medical record reviews based on CMS Quality Standards and validating active chronic problems for each patient and communicating with the physician to ensure Hierarchical Condition Coding is met, as well as accurate and up-to- date patient problem lists are documented in the EMR. This position will interact with physicians, coding staff and other members of the health care team to ensure the accuracy and completeness of clinical documentation to support resource utilization and patient outcomes. The ECA reports to the Population Health Manager. It is the obligation of each Galen associate to comply with and promote the Galen mission, core values, privacy and corporate/departmental/site policies (I.E. Dress code, Time and attendance, et al).

Requirements

Education Must be certified as procedural coder and maintain certification throughout employment.
Must have strong analytical, oral and written communication skills.
Experience Minimum of two years of healthcare experience required with one-year clinical experience preferred.
Minimum of two years of customer service experience required.
Skills/Certifications Excellent customer service skills.
Exceptional skills of independence, organization, verbal and written communication, problem-solving, professional interaction, and human relation skills, as well as analytical skills and problem-solving ability.
Must be PC literate with strong computer navigational skills, as well as extensive knowledge of Windows and Microsoft Office.
Knowledge of basic medical terminology.
Proficient with processes to build teams and participate in cross-functional teams.
Ability to work within specified timeframe requirements, including timeframes for goal achievement.
Perform all duties in compliance with Galen Medical policies, HIPAA, and OSHA standards.

Nice To Haves

Associates Degree in related field preferred.

Responsibilities

Coordinate Patient Services Perform medical chart reviews to confirm adherence to AAPC clinical coding guidelines.
Complete audits daily to validate compliance with quality standards and HCC documentation.
Queries the provider to educate and improve individual patient documentation in the EMR.
Protects self and other team members by following all compliance, HIPAA and infection prevention guidelines and regulations.
Respects patients by recognizing their rights; maintaining confidentiality.
Assist patient’s primary care provider with coordination of care/services to ensure the smooth transfer of member information across the continuum of care.
Maximize the use of resources to improve quality outcomes with reduction of unnecessary tests/procedures maintaining accurate and complete documentation in the medical record.
Proactively engage with patients, family and/or caregivers to educate and coordinate completion of necessary procedures or tests.
Establish and Maintain Quality Care Population Health Coordination Independently monitors and reviews an assigned patient population.
May provide telephonic outreach to patients identified as high risk, with chronic condition(s) to assist with medical record requests, as needed.
Thorough understanding of ICD-10, CPT and complex co-morbidity coding.
Participate in monthly and quarterly meetings, as requested by supervisor.
Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, benchmarking state- of-the-art practices and participating in professional organizations regarding clinical quality measures and governmental regulations.
Other duties as assigned.