Provider Coding Auditor & Educator (Remote)

Anne Arundel Dermatology • Owings Mills, MD

1d • $75,000 - $85,000 • Remote

About The Position

We are seeking an experienced Professional Fee Coding Auditor & Educator to partner with physicians and APPs on coding accuracy, documentation improvement, compliance, and provider education. Must currently possess both the CPC and CPMA certifications in order to be considered for the role. The Coding Auditor and Educator role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. This is an experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation or deviation from standard procedures, and communicates information that requires some explanation or interpretation. This position has frequent and daily interactions with Medicine Professional Group physician and non-physician providers. Responsibilities include supportive coding instruction related to primary diagnosis and procedural coding and ensuring the accuracy of coding and documentation of appropriate E/M visit level and inclusion of ICD-10-CM diagnosis codes. The coder will focus on chart reviews, the detailed physician chart abstraction, related coding education, evaluation of denials, and ensuring regulatory compliance. The coder will share feedback to providers to capture the full scope of work, collaborate with billing specialists on denials and interact with ModMed to ensure a smooth workflow for providers.

Requirements

• Must currently possess both the CPC and CPMA certifications in order to be considered for the role.
• Extensive knowledge of E&M coding surgical procedures, applicable modifiers.
• Understands and apply appropriate Center Medicare Services guidelines to coding.
• Advanced ICD-10-CM & CPT-4 coding conventions.
• Knowledge of Anatomy & Physiology and Medical Terminology.
• Ability to become a ModMed expert to help providers utilize the system to improve documentation and how EMA is coding.
• Effective written and verbal communication skills.
• Comfortable to present to large groups of providers on coding topics and answer questions in real time.
• Ability to work independently and use time effectively to complete audits and deliver the results to each provider in a time fashion with a written report with suggestions on improvements in their documentation and coding accuracy.
• Have a solid knowledge of what is on the Inspector General watch list for coding and compliance as well as various payers medical necessity to ensure that providers individually and the organization are set up to minimize any audit risks.
• Associates degree
• Completion of Certified Medical Coding Program or two years of professional coding certification with courses in Medical Terminology, Anatomy & Physiology and/or extensive training in physician billing coding
• Four (4) years of coding experience, with at least two (2) years in surgical abstraction (physician billing practices, i.e..).

Nice To Haves

• Preferred dermatology experience.

Responsibilities

• Supports codes from final surgical/procedural operative reports signed by the provider.
• Reviews the complex (problematic coding that needs research and reference checking) medical records, ensures documentation is supported.
• Works with ModMed to ensure that the correct plans are used, modifiers attached and diagnosis attached.
• Audits provider medical records and charges for compliance with coding and documentation standards to ensure compliance with internal and government regulations.
• Provides continuing review and education of physician and ACPs to ensure appropriate level of care is reported.
• Partner with practices to review findings of the periodic chart review.
• Maintains a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM and CPT coding guidelines to diagnoses and procedures in offices.
• Correlates information supporting clinical documentation not limited to Pathology, Radiology and/or other Physician Consultations after review by the Attending Physician, wherever appropriate.
• Regularly meets with physicians and ACPs to provide continuous education on billable services, medical record documentation, the correct use of CPT and ICD-10 codes, missed billing opportunities and erroneously reported services to minimize errors and loss of revenue.
• Interacts with and provides trends to management, revenue managers and others about coding related issues.
• Solves any coding related problems and/or answers questions regarding coding issues from the provider, office staff and billing specialists.
• Collaborates with billing specialists and appeal and edit coders to expedient resolution of accounts.
• Works together with billing specialists to develop plans to improve charge capture and billing/coding processes.
• Stays current with CPT and ICD-10-CM coding guidelines and updates.
• Communicate changes and/or updates to key stakeholders including physicians, ACPs, practice managers and leadership.
• Reports any potential compliance issues to the Director of RCM.

Benefits

• Medical, Dental & Vision insurance – effective 1st of the month after date of start
• Short-term and long-term disability, Voluntary life (employee, spouse, and child), Critical Illness, and Hospital Indemnity – Effective the 1st of the month following date of hire
• Company provided Basic Life/AD&D insurance
• Paid time off
• Paid holidays
• Retirement Savings account
• Employee discount on cosmetic services and products

What This Job Offers

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