Regulatory Services Auditor

Physicians East•Greenville, NC

9d•Hybrid

About The Position

Physicians East, P.A. is seeking a Regulatory Services Auditor to join their fast-paced multispecialty physician group. This role is primarily remote, with periodic travel to Physicians East locations for delivering audit findings and conducting provider education. The position involves a combined training approach of virtual meetings and in-person sessions. The candidate must be located in North Carolina.

Requirements

Associates degree or Bachelors degree in Health Information Management with RHIT/RHIA certification and 3-5 years of multi-specialty ICD-10 and CPT experience, or
Bachelor’s degree in health care related field with CPC/CCS-P/CPMA certification and 2-4 years of direct ICD-10 and CPT experience, or
CPC/CCS-P/CPMA certification with 4-6 years of multi-specialty ICD-10 and CPT experience.

Responsibilities

Conducts provider and coder audits to ensure coding levels and charting meets standards and regulations
Educates providers and team members on compliance audit findings or when problems are identified
Develops ongoing educational content to present to coding department and providers
Responsible for being up-to-date and knowledgeable of coding process and diagnostic procedures as well as carrier specific policies, guidelines, and updates
Shares information as necessary with the Coding & Insurance department
Provides training and serves as a general resource to assist coders and members of department staff
Provides information to providers and team members on current coding practices and changes in regulations and guidelines
Collaborates with team leadership to address coding trends
Utilizes coding resources or applicable reference materials to ensure accurate coding
Understand billing and coding requirements for government and commercial payers
Provide other assistance to the Coding or Insurance Department as directed by the Regulatory Services Leadership
Maintains patient confidentiality
May serve as a backup for coding in times of peak workload
Assist with special projects as assigned by leadership
Ability to work independently and proficiently in a remote office environment
Attends meetings when required (onsite/remote)