Physician Auditor / Coder

MedKoder•Chicago, IL

8d•Remote

About The Position

Medkoder is looking for an experienced multi-specialty, certified professional coder with extensive knowledge of coding and auditing, for various E/M and surgical auditing projects with our clients. This is a FT REMOTE permanent position that offers the opportunity to work a flexible schedule.

Requirements

Education/Cert: A minimum of a high-school diploma, Associates Degree preferred. Successful completion of at least one AHIMA or AAPC certified program with achievement of the correlating professional credential (CCS, CPC, etc.); active and in good standing, preferably a combination of two or more credentials. A CPMA certification is required.
Experience: Minimum 3 years physician coding experience and 3 years E&M and surgical auditing experience required. Must have proficient knowledge of medical terminology, CPT and/or ICD-9/10 coding and Medicare and Medicaid billing policies for professional services.
Additional skills required: Experience with Microsoft Word, Excel, PowerPoint, Windows and healthcare information and billing systems. Experience working independently, excellent time management skills and the ability to meet project deadlines a must.

Responsibilities

Performing audits of E/M coding and documentation compliance audits for providers, including physicians and mid-level providers
Accurate application of appropriate coding and documentation guidelines, including Evaluation and Management Documentation Guidelines, CPT Coding Guidelines, Coding Clinics, Specialty Association guidance and others, as applicable
Accurate selection of CPT codes to determine if the code was assigned without appropriate documentation to support the code (up-coded services)
Accurate selection of CPT codes to determine if the code was assigned with documentation to support a higher level service (down-coded services)
Accurate selection of CPT codes for procedures performed
Accurate application of modifiers to CPT codes
Accurate selection and evaluation of ICD-10 CM diagnosis coding
Evaluate the overall quality of physician documentation that supports codes selected including adherence to Medical Necessity
Adherence to Local Coverage Determination (LCDs), or National Coverage Determination (NCDs), if applicable; National Correct Coding Initiative (NCCI) edits, and payor specific policies, if applicable
Appropriateness of documentation for split/shared or incident to services
Appropriateness of provider’s documentation related to Teaching Physician Guidelines, PQRS, FQHC and RHC's as applicable
Use scoring methodology to accurately score audits
Provide detailed findings for each service reviewed on an excel spreadsheet or other customized report, including supporting documentation
Communicate with Coding Team Lead on audit timeline task completion.