Revenue & Training Specialist - Chart Audit

The Employment Team at Hattiesburg Clinic, P.A.•Hattiesburg, MS

About The Position

The Revenue & Training Specialist is a multifaceted role responsible for supporting audit processes, ensuring compliance, and providing education in medical coding and documentation standards. In this position, the employee will assist the Revenue Analyst with Procedure and Recovery Audit Contractor (RAC) audits, ensuring that all audits are completed in a timely manner. The role also involves reviewing medical records for accuracy, quality assurance, and billing compliance, as well as conducting internal audits and staying current with policy and procedural guidelines to ensure proper coding practices are followed. The specialist will promote compliance by reviewing provider charts, delivering feedback and education to providers, and preparing and conducting training sessions for coders. In addition, the position provides support for the HCC Auditor by assessing medical records to determine appropriate HCC/ICD-10 codes and verifying compliance with healthcare policies and standards. Another key responsibility is providing medical coding instruction to coders, which includes developing curricula, creating PowerPoint presentations, leading educational sessions, and addressing coder questions. The role may also require assisting with coding work queues during staff absences, closeout periods, or when workload levels are elevated by management.

Requirements

Graduate from a school of nursing (LPN or RN), required
If candidate is a graduate from a school of nursing without coding certification, then AAPC (CPC and CRC) certifications must be obtained within 6 months of hire
If candidate already has Certified Professional Coder (CPC) certification through the AAPC, then a Certified Professional Medical Auditor (CPMA) must be obtained within 6 months of hire
Knowledge of ICD-10, CPT, and HCPCs codes, required
Must have thorough knowledge and experience in Medicare rules and regulations and billing and coding principles
Ability to maintain strict confidentiality and handle sensitive information with discretion
Strong communication skills, both oral and written, as communication with providers and managerial staff is required.
Knowledge and experience in Medicare rules and regulations, coding and billing principles.
Must be motivated and possess strong communication, problem solving, and capable of working effectively with physicians and non-physicians.
Must have strong oral presentation skills as group presentations may be required.
Must possess strong organizational skills, as well as the ability to complete multiple tasks within a designated time frame.

Responsibilities

Assist the Revenue Analyst with Procedure and Recovery Audit Contractor (RAC) audits
Review medical records for accuracy, quality assurance, and billing compliance
Conduct internal audits
Stay current with policy and procedural guidelines to ensure proper coding practices are followed
Promote compliance by reviewing provider charts
Deliver feedback and education to providers
Prepare and conduct training sessions for coders
Provide support for the HCC Auditor by assessing medical records to determine appropriate HCC/ICD-10 codes and verifying compliance with healthcare policies and standards
Provide medical coding instruction to coders, which includes developing curricula, creating PowerPoint presentations, leading educational sessions, and addressing coder questions
Assist with coding work queues during staff absences, closeout periods, or when workload levels are elevated by management.