Remote Medical Coding Auditor (CPC, CCS-P, or CPMA)

Crossroads Treatment Centers•Greenville, SC

1d•Remote

About The Position

Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder. Crossroads is a family of professionals dedicated to providing the most accessible, highest quality, evidence-based medication assisted treatment (MAT) options to combat the growing opioid epidemic and helping people with opioid use disorder start their path to recovery. This comprehensive approach to treatment, the gold standard in care for opioid use disorder, has been shown to prevent more deaths from overdose and lead to long-term recovery. We are committed to bringing critical services to communities across the U.S. to improve access to treatment for over 26,500 patients. Our clinics are all outpatient and office-based, with clinics in Georgia, Kentucky, New Jersey, North and South Carolina, Pennsylvania, Tennessee, Texas, and Virginia. As an equal opportunity employer, we celebrate diversity and are committed to an inclusive environment for all employees and patients. Day in the Life of a Medical Coding Auditor Conducting audits of claims and patient records to identify incorrect coding. Audits will be performed for both provider and coder coding accuracy with required documentation in accordance with current coding guidelines. Developing, implementing, and coordinating corrective action proposals and plans. Tracking completion of internal and external Plans of Correction. Preparing reports of findings and any compliance issues identified with audits, including monthly summary reports for the Crossroads executive team and quarterly reports for the Chief Compliance Officer. Attending and reporting at weekly team calls with Manager of Medical Coding Compliance Audits, Director of Medical Coding Compliance and Chief Compliance Officer. Attending weekly meetings with other auditors. Reporting coding patterns identified within the audit process to management and identifies corrective measures to compliance problems. Assisting the Manager of Medical Coding Compliance Audits with training and education of providers, coders, and centers (OBOTs and OTPs) on medical coding compliance. Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-10 materials, the Federal Register, and other pertinent materials. May interact with providers and/or center administrators from time to time regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation. Provide coding and compliance updates to all staff. Collaborates with interdepartmental or cross-functional teams for assigned projects and provides departments with identified coding issues and updates to ensure timely and accurate reimbursement. Determines method of completing daily workload and priorities to ensure that all responsibilities are carried out in a timely manner. Assisting with pulling records requested by payers related to payer audits and review of such records to identify any issues. Other duties and responsibilities pertaining to medical coding compliance monitoring as requested by the Director of Medical Coding Compliance Director of Medical Coding Compliance. Schedule, Travel, & Work Authorization Employees must work 8-hour shifts Monday through Friday and may clock in as early as 6:30 AM EST, but no later than 9:00 AM EST. Employees may not clock out before 4:00 PM EST.

Requirements

Certified Professional Coder (CPC), Certified Coding Specialist- Professional (CCS-P) or Certified Professional Medical Auditor (CPMA)
High School diploma, GED or equivalent.
Minimum of 5 years of coding experience.
Minimum of 2 years of auditing experience.
Experience in auditing healthcare provider documentation to identify correct ICD-10-CM, CPT, and/or HCPCS codes preferred.
An excellent understanding of Mental Health / Opioid Addiction medical terminology preferred.
An excellent understanding of ICD-10-CM coding classification and CPT/HCPCS coding.
Computer literate adept skill level on MS Office applications.
Good organizational and communication skills.
Task oriented and ability to meet designated deadlines and productivity standards.
Strong, well-developed interpersonal skills.

Nice To Haves

Experience in Mental Health or Addiction Medicine a plus.

Responsibilities

Conducting audits of claims and patient records to identify incorrect coding.
Audits will be performed for both provider and coder coding accuracy with required documentation in accordance with current coding guidelines.
Developing, implementing, and coordinating corrective action proposals and plans.
Tracking completion of internal and external Plans of Correction.
Preparing reports of findings and any compliance issues identified with audits, including monthly summary reports for the Crossroads executive team and quarterly reports for the Chief Compliance Officer.
Attending and reporting at weekly team calls with Manager of Medical Coding Compliance Audits, Director of Medical Coding Compliance and Chief Compliance Officer.
Attending weekly meetings with other auditors.
Reporting coding patterns identified within the audit process to management and identifies corrective measures to compliance problems.
Assisting the Manager of Medical Coding Compliance Audits with training and education of providers, coders, and centers (OBOTs and OTPs) on medical coding compliance.
Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-10 materials, the Federal Register, and other pertinent materials.
May interact with providers and/or center administrators from time to time regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation.
Provide coding and compliance updates to all staff.
Collaborates with interdepartmental or cross-functional teams for assigned projects and provides departments with identified coding issues and updates to ensure timely and accurate reimbursement.
Determines method of completing daily workload and priorities to ensure that all responsibilities are carried out in a timely manner.
Assisting with pulling records requested by payers related to payer audits and review of such records to identify any issues.
Other duties and responsibilities pertaining to medical coding compliance monitoring as requested by the Director of Medical Coding Compliance Director of Medical Coding Compliance.

Benefits

Medical, Dental, and Vision Insurance
PTO
Variety of 401K options including a match program with no vesture period
Annual Continuing Education Allowance (in related field)
Life Insurance
Short/Long Term Disability
Paid maternity/paternity leave
Mental Health Day
Calm subscription for all employees
Have a daily impact on many lives.
Excellent training if you are new to this field.
Mileage reimbursement (if applicable) Crossroads matches the current IRS mileage reimbursement rate.
Community events that promotes belonging and education. Includes but not limited to community cook outs, various fairs related to addiction treatment and outreach, parades, addiction awareness for schools, and holiday events.
Opportunity to save lives everyday!