External Auditor Physician

Omega Healthcare Solutions • Boca Raton, FL

1d • $33 - $39 • Remote

About The Position

Under general supervision of the client, the External Auditor Physician reviews professional services medical records for coding accuracy and documentation that affects the accuracy of ICD-10-CM and CPT-4/HCPCS codes, including appropriate modifiers. The role identifies physician query opportunities, writes compliant queries, and develops recommendations supported by references. The position also collects data for quality and statistical purposes and reports findings to Omega’s clients.

The position reviews physician services medical records for coding accuracy and data quality, including diagnoses and procedures, CPT/HCPCS codes, modifier use and assignment, and E&M leveling. It maintains productivity in line with requirements agreed upon by the client and Omega, completes quality review reports on time, and uses official coding references and guidelines. Duties must comply with company policies and procedures, including HIPAA and compliance requirements.

This full-time or part-time/PRN position is performed in a remote home office environment. Workdays and hours are flexible; the position occasionally requires long hours and weekend work. Minimum travel is required, up to 5%.

Requirements

• Associate’s degree or equivalent training acquired through on-the-job experience.
• At least two years of HIM experience; auditor experience is preferred, though a strong E/M coder will also be considered.
• At least three years of E/M coding or audit experience.
• Minimum CPC certification from AAPC or CCS-P certification from AHIMA.
• Ability to prioritize and multitask in a multifaceted environment.
• Strong organizational skills and attention to detail.
• Ability to self-motivate, set goals, and meet deadlines.
• Leadership, mentoring, and interpersonal skills.
• Excellent presentation, verbal, and written communication skills.
• Ability to develop and maintain relationships with key business partners by building personal credibility and trust.
• Ability to maintain courteous and professional working relationships with employees at all levels.
• Excellent analytical, critical-thinking, and problem-solving skills.
• Ability to identify deficiencies and take corrective action.
• Proficient personal computer skills.

Nice To Haves

• Auditor experience; a strong E/M coder will also be considered.

Responsibilities

• Review physician services medical records for coding accuracy and data quality, including assigned ICD-10-CM diagnosis and procedure codes, CPT/HCPCS codes, modifiers, and E&M leveling codes.
• Identify physician query opportunities and write compliant queries.
• Create appropriate recommendations with supporting references.
• Maintain auditing productivity according to requirements agreed upon by the client and Omega.
• Complete quality review reports on time and submit them to the client for review.
• Use available official coding references and guidelines to perform reviews, including ICD-9-CM, CPT-4 Official Coding Guidelines, Coding Clinic, CPT Assistant, and CMS guidelines.
• Collect data for quality and statistical purposes and report findings to Omega’s clients.
• Perform duties in compliance with company policies and procedures, including HIPAA and compliance requirements.

Benefits

• Health coverage
• Dental coverage
• Vision coverage
• Voluntary insurance options
• 401(k) plan with employer match
• Professional development opportunities
• Paid time off
• Holiday pay
• Eligible employees may have the opportunity to participate in bonus programs, commissions, or other variable incentive plans.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree