Physician Practice E&M Auditor Educator, BHMG Auditing & Coding, FT, 8A-4:30P
About The Position
The E&M Coding Auditor/Educator performs comprehensive audits to determine the integrity of coding/billing for physician & clinical fees, detection/correction of documentation, coding/billing errors and/or medical necessity of services billed. Audits consist of evaluation of the accuracy of documentation, including E/M and other payer codes, medical necessity, reimbursement overpayments and underpayments, and compliance with other documentation standards. Researches and applies all federal guidelines & compliance with the overall audit delivery. Develops and executes provider comprehensive educational opportunities/curriculums (coding resources, materials, tools, webinars, campaigns, etc.) based on audit results, noted trends & changes within coding compliance and regulatory guidelines, while supporting organizational compliance models. Leads provider‘s education events to discuss overall audit results overview, identifying trends and action plans. Provides support or project management for any other related audit and coding initiatives and assist in other related responsibilities as required by executive leadership team. Establishes positive working relationships as the subject matter expert with all parties to provide input on risk and ensure a sustained understanding of federal coding compliance requirements.
Requirements
- High School, Cert, GED, Trn, Exper.
- AAPC Certified Professional Medical Auditor.
- AHIMA Certified Coding Specialist-Physician-based.
- AAPC Certified Professional Coder.
- Prior Physician Coding & Auditing, Revenue Cycle or billing related to Coding.
- Upon Hire, CPC-Certified Professional Coder and/or CCS-P-Certified Coding Specialist-Physician required.
- CPMA-Certified Professional Medical Auditor upon hire or must be completed within 1 year.
- Overall experience to include at least 2 years of professional E&M coding experience and 2 years of E&M provider education experience.
- Strong knowledge of E&M regulations and CMS Documentation Guidelines.
- Successful experience with data abstraction and analyze patient encounters for a focused review sample and development of comprehensive coding education materials and resources.
- Proficient in ICD10CM, CPT and HCPCS coding, policy and procedures based on physician practices.
- Strong organizational skills and attention to detail.
- Ability to prioritize provider medical record reviews/projects and provider coding education opportunities with alignment with audits and overall trends.
- Work independently with little or no supervision.
- Ability to provide excellent customer service.
- Excellent computer skills and proficient in Microsoft Office and generating reports.
- Minimum Required Experience: 4 Years
Responsibilities
- Performs comprehensive audits to determine integrity of coding/billing for physician & clinical fees.
- Detects and corrects documentation, coding/billing errors and/or medical necessity of services billed.
- Evaluates accuracy of documentation, including E/M and other payer codes, medical necessity, reimbursement overpayments and underpayments, and compliance with other documentation standards.
- Researches and applies all federal guidelines & compliance with the overall audit delivery.
- Develops and executes provider comprehensive educational opportunities/curriculums based on audit results, noted trends & changes within coding compliance and regulatory guidelines.
- Supports organizational compliance models.
- Leads provider‘s education events to discuss overall audit results overview, identifying trends and action plans.
- Provides support or project management for any other related audit and coding initiatives.
- Assists in other related responsibilities as required by executive leadership team.
- Establishes positive working relationships as the subject matter expert with all parties to provide input on risk and ensure a sustained understanding of federal coding compliance requirements.
Benefits
- Career growth and development opportunities, with clear pathways and ongoing support
- Comprehensive health and wellness resources that go beyond traditional benefits
- A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs
- Tuition reimbursement to support continued learning and advancement
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
