Medical Auditor

Methodist Health System•Dallas, TX

80d•Onsite

About The Position

Perform audits of documentation integrity and coding compliance by regulatory standard for professional evaluation and management & surgical services for the coding compliance department of Methodist Medical Group. Methodist Medical Group is the North Texas physician organization affiliated with Methodist Health System. Our fast-growing network of providers includes more than 92 MMG ambulatory clinics, an urgent care clinic, and a virtual care service known as MethodistNOW.

Requirements

High school education or equivalent; some college credit; Bachelor degree preferred.
Certified Professional Medical Auditor (CPMA) certification from AAPC preferred.
Certified Professional Coder (CPC) certification from AAPC or Certified Coding Specialist – Physician-based (CCS-P) certification from AHIMA with 2+ years of experience in auditing and abstracting.
2+ years of multispecialty auditing medical documentation for appropriate E&M level and CPT assignment.
Thorough knowledge of medical terminology.
Proficient with Microsoft Word and Excel.
Experience with Epic preferred.
Ability to communicate effectively via written and verbal communication.
Ability to research payer and federal regulatory sites.
Excellent knowledge of guidelines for ICD-10-CM, CPT®, HCPCS, and regulatory guidance.
Knowledge of CMS split/shared, teaching physician, incident-to, and scribe documentation guidelines.
Critical thinking skills to assess and comprehend documentation in various forms within the medical record.

Nice To Haves

Bachelor degree preferred.
Certified Professional Medical Auditor (CPMA) certification from AAPC preferred.
Experience with Epic preferred.

Responsibilities

Audit coder assigned E&M levels and surgical/procedural codes against provider documentation for quarterly compliance program auditing requirements.
At the direction of the Director/Audit Manager, perform random risk audits for areas of concern to assure documentation standards are being met for billing/coding purposes.
Perform cyclical quality audits on all coders to ensure accuracy rates above department standard minimums.
Assist in training and education of coders and staff on compliance billing and coding principles for government and commercial payers.
Adhere to patient and office confidentiality guidelines as outlined by the policies and procedures of MMG and MHS as well as HIPAA, red flag regulations, and any other polices that relate to compliance to federal program guidelines.
Supports the mission, vision, values and strategic goals of the Methodist Health System and the Methodist Medical Group.
Other duties as assigned.