External Auditor Physician

Omega Healthcare Management Services • Boca Raton, FL

4d • Remote

About The Position

Under general supervision of client, Omega’s External Auditor Physician will perform reviews of inpatient and outpatient or Professional Services medical records for coding accuracy and medical record documentation as it impacts the accuracy of ICD-10-CM, ICD-10-PCS codes driving MS-DRG assignment and ICD-10-CM and CPT-4/HCPCS codes driving the APC assignment. The External Auditor Physician must be able to identify Physician query opportunities, write compliant queries, assess the accuracy of POA, discharge disposition and modifier assignments. External Auditor Physician performs data collection for quality and statistical purposes and reports the findings to Omega’s clients.

Requirements

• Associate’s Degree or equivalent training acquired through on-the-job experience.
• Must have at least two years of HIM experience, preferably as an Auditor.
• At least one year of auditing experience.
• Minimum of successful completion of an AHIMA approved Coding Certificate Program.
• CCS, CPC, CPC-P, CPC-H, RHIA or RHIT

Nice To Haves

• None.

Responsibilities

• Review inpatient, outpatient, or physician services medical records for accuracy of coding and data quality.
• Elements to be included in reviews can include: Inpatient/Observation Cases: All diagnosis and procedure assigned ICD-10-CM and ICD- 10 PCS codes, Discharge disposition assigned, Assigned Present on Admission (POA) indicators, APR, SOI, and ROM assignment for inpatient cases.
• Outpatient Cases (ER, SDS, Ancillary): All diagnosis and procedure assigned ICD-10-CM and ICD-10 PCS codes, All CPT assigned codes, Modifier use and assignment, APC assignment.
• Professional Services: All diagnosis codes assigned ICD-10 CM, All CPT codes, All E&M Leveling codes.
• Maintain auditing productivity based on Client and Omega agreed upon requirements.
• Complete Quality Review reports timely and submits to Client for review.
• Utilize all available official references to perform reviews: to include but not limited to International Classification of Diseases, 9 th Edition, Clinical Modification (ICD-9-CM), the Current Procedural Terminology (CPT-4) Official Coding Guidelines, Coding Clinic, CPT Assistant, CMS guidelines, etc.
• Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.

Benefits

• Equal Employment Opportunity: Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.
• Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at [email protected].

What This Job Offers

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