Remote Pro Fee Auditor/Educator

Presbyterian Healthcare Services

44d • $54,517 - $83,262 • Remote

About The Position

Build your Career. Make a Difference. Presbyterian is hiring a skilled Remote Pro Fee Auditor/Educator to join our team.

Requirements

• High school diploma/GED required.
• Must possess at least one of the following license/certifications: RHIT, RHIA, CPC, CCS and a minimum of three (3) years experience in coding and/or auditing required.
• Audit experience preferred.
• Excellent written and verbal communication skills.
• Excellent written and verbal communication skills.
• Detail and results oriented.
• Ability to work independently and make independent decisions.
• Medical terminology, ICD-9, CPT-4 and HCPCS knowledge required.
• Must have a proficient knowledge of Medicare, Medicaid, and other third party payer documentation, coding, and billing regulations for service lines(s) assigned.
• Must possess excellent organizational and planning skills, including the ability to prioritize multiple tasks and perform them both accurately and simultaneously.
• Must possess computer skills, especially with Microsoft Word, PowerPoint, and Excel applications.
• Must be able to use the internet and other resource applications for research purposes and to provide documentation that supports regulations quoted in audits.
• Must possess strong written and verbal communication skills in order to communicate in clear, concise terms to management at all levels, including the ability to articulate complex regulatory information in laymans terms.
• Must possess a personal presence of a highly qualified professional that is characterized by a sense of honesty, integrity, and the ability to inspire and motivate others.

Responsibilities

• Liaison to the Manager, Information Services, Finance/Patient Financial Services, all hospitals, all PMG sites, PHP, Home Health, Albuquerque Ambulance, Compliance and all ancillary departments in addressing functional coding, auditing, compliance and training issues and problems.
• Interacts with all levels of management.esponsible for maintaining accurate, complete and timely documentation in either electronic or hard copy form
• Must be able to adapt to frequently changing work priorities and schedules.
• Maintains and disseminates up-to-date technical knowledge of legal and regulatory information from all appropriate jurisdictions concerning the given business area. This includes but is not limited to all ICD-9, ICD-10, CPT-4, HCPCS and APC updates and changes
• Researches coding, billing and charging compliance issues, recommends and implements corrective action plans that assure compliance with regulatory agencies where appropriate.
• Identifies risks, develops and follows up on action plans, identifies lost revenue opportunities and any overpayments due to errors in coding and/or documentation, and provides compliance education
• Assists in the creation of the CDQA Annual Audit Work-plan by utilizing the OIG work plan, Medicare and Medicaid regulations, RAC and other audit agency focuses, as well as internal and external risk assessments
• Regularly exercises independent judgment in determining the reliability of data reviewed; recommends changes in existing practices to gain or maintain compliant behavior.
• Keeps actively informed on the business climate of the healthcare industry
• Responds to inquiries and requests daily regarding coding and auditing issues and problems and ad-hoc analysis for all PHS management

Benefits

• All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
• Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being.
• Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees