Medical Coding Auditor-Educator

2 weeks ago


New Providence, United States PRISM Vision Group Full time
*Role and Responsibilities*

* Assist the Director of Compliance in creating and further coordinating the Compliance Audit Plan.
* Conduct internal billing and coding audits of medical record documentation and claims to identify coding errors.
* Prepare summary reports of findings and meet with physicians and staff to provide education and training on accurate and appropriate documentation practices.
* Research, analyze, and respond to inquiries regarding appropriate documentation and coding, denials, and billable services.
* Identify documentation gaps and develop processes for improvement.
* Collaborate with providers, Revenue Cycle department, Operations Directors and Managers, and others as appropriate, to coordinate billing and documentation policies, procedures, and regulations; obtain clarification of conflicting, ambiguous, or non-specific documentation.
* Collaborate with providers, Revenue Cycle department, Operations Directors and Managers, and others as appropriate, to review and/or implement codes and to update charge documents.
* In certain instances, the Medical Coding Auditor-Educator will act as the liaison between the auditing vendor and Prism Vision Group in coordinating audits
* Perform miscellaneous job-related duties as assigned.

*_Education, Training and Experience_*

* High School diploma or GED.
* Certificate in Medical Coding (CPC or similar certificate from AAPC or AHIMA) or at least 2- 3 years of experience directly related to the duties and responsibilities specified.
* CPMA certification a plus but not required.
* Proficiency in or experience with General Ophthalmology and/or Retina coding and/or auditing strongly preferred but not required.

*_Knowledge and Skills/Expected Competencies_*

* Detail-oriented and organized.
* Proficient in Microsoft Office Suite software and Windows 10.
* Knowledge of auditing concepts and principles.
* Familiarity with or have experience with pulling electronic medical records and reports from the EMR and billing databases.
* Advanced knowledge of medical coding and billing systems and regulatory requirements.
* Ability to use independent judgment and to manage and impart confidential information.
* Strong communication and interpersonal skills.
* Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation, including Medicare and Medicaid program rules
* Detailed knowledge of medical coding and billing systems, procedures, and documentation requirements.

#indpvg

Job Type: Full-time

  • Providence, United States Care New England Full time

    Job DescriptionJob Description*This position will be a hybrid schedule.*Job Summary:Provides audit support and guidance to management, providers, residents, and support staff in free-standing and facility-based practices.Conducts assigned facility compliance audits for risk areas identified through the analysis of internal data and external sources.Ensures...


  • New York, United States MJHS Full time

    Our Corporate team may not provide direct care, but we still touch people's lives in a very real and substantial way. The services we provide contribute greatly to the overall patient and member experience, supporting our reputation for excellence. Under the direction of the MJHS Compliance Officer and working closely with members of the MJHS Compliance...

  • Premium Auditor

    11 hours ago


    Providence, United States Afirm Solutions Full time

    Job DescriptionJob DescriptionEntrepreneurs Wanted!  Are you tired of working for someone else?  Have you thought about building a business for yourself?  If you answered yes to either question – Welcome!  We are excited to introduce Afirm to you!  Our field auditors come from all walks of life and various backgrounds.  They are inquisitive, driven...


  • New York, United States VillageCare Full time

    Are you a Registered Nurse with a passion for ensuring compliance? Join our team at VillageCare as a Full-Time Clinical Compliance Auditor and take the next step in your career from the comfort of your own home. This fully remote position offers a competitive salary ranging from $102,000 to $115,000, providing a rewarding opportunity for professional growth...


  • New York, United States Metropolitan Jewish Health System Full time

    Overview: Our Corporate team may not provide direct care, but we still touch people's lives in a very real and substantial way. The services we provide contribute greatly to the overall patient and member experience, supporting our reputation for excellence. Why work for MJHS?: When you work with us you will receive comprehensive and affordable health and...


  • New York, United States TAL Healthcare Full time

    Job DescriptionJob DescriptionSenior Compliance Coding AuditorOur client, a top NYC academic medical center, is currently seeking to hire a Senior Compliance Coding Auditor.Responsibilities:• Participate in external government audits, including the OMIG, OIG, AG, OSC etc• Communicate with external agencies regarding audits.• Participate in development...


  • New York, United States Village Care Full time

    Job DescriptionJob DescriptionAre you a Registered Nurse with a passion for ensuring compliance? Join our team at VillageCare as a Full-Time Clinical Compliance Auditor and take the next step in your career from the comfort of your own home. This fully remote position offers a competitive salary ranging from $102,000 to $115,000, providing a rewarding...

  • Compliance Auditor

    3 weeks ago


    New Haven, United States Yale University Full time

    Coordinate and conduct medical billing audits for the Yale Medicine Administration. Evaluate medical billing, coding and documentation for 18 clinical departments under the direction of the Compliance Officer. Provide training and feedback to physici Auditor, Audit, Compliance, Medical Billing, Compliance Officer, Accounting


  • Providence, United States Arthur J. Gallagher & Company Full time

    Primarily focused on the development, maintenance, and assurance of accurate and quality reporting, analysis of pharmacy and medical benefit utilization, and cost modeling. Key accountabilities include providing analytical expertise in the developmen Auditor, Audit, Pharmacy, Pharmacy Technician, Senior, Project Management, Accounting, Insurance


  • Providence, United States Community Action Partnership of Providence Full time

    Job Type Full-time Description Job Purpose: Energy Auditors are responsible for conducting comprehensive and precise residential home energy assessments in accordance with agency, utility, and Government standards. Energy Auditors are tasked with educating clients about how to make their homes safer and more energy-efficient. Reports to: Weatherization...

  • Regional SOX Auditor

    20 hours ago


    Providence, United States Bally's Corporation Full time

    Description Why Bally's? Bally's Corporation is one of the world's leading entertainment companies, with millions of players across digital gaming platforms and traditional casino venues. Recognized for our innovation, energy, and dedication to creating thrilling gaming experiences, we were born to entertain. A career with Bally's means starting on a path to...


  • New York, New York, United States tapwage Full time

    OneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer. Our team is bringing together leaders to the market place to help drive OneOncology's mission and vision.Why join us? This is an exciting time...

  • Lead Auditor

    3 days ago


    New York, United States X4 Life Sciences Full time

    A lead Notified Body client of X4 Life Sciences is looking to add a Lead Auditor for Medical Devices to it's rapidly growing, dynamic team. About The Role This role is for medical device certification. The main responsibilities of this role are: Responsibility for achieving his/her own KPI-targets Efficiently and competently implement ISO13485 & MDD & MDR...

  • Auditor

    1 week ago


    New York, United States EPM Scientific Full time

    Join one of the leading Notified Bodies in the medical device industry and contribute to ensuring the safety and efficacy of medical devices worldwide. Our organization is committed to upholding the highest standards of regulatory compliance and quality assurance to safeguard patients and healthcare professionals. Position Overview: We are seeking a highly...

  • Lead Auditor

    4 days ago


    New York, United States X4 Life Sciences Full time

    A lead Notified Body client of X4 Life Sciences is looking to add a Lead Auditor for Medical Devices to it's rapidly growing, dynamic team. Read all the information about this opportunity carefully, then use the application button below to send your CV and application. About The Role This role is for medical device certification. The main responsibilities...

  • Lead Auditor

    5 days ago


    New York, United States X4 Life Sciences Full time

    A lead Notified Body client of X4 Life Sciences is looking to add a Lead Auditor for Medical Devices to it's rapidly growing, dynamic team.About The RoleThis role is for medical device certification. The main responsibilities of this role are:Responsibility for achieving his/her own KPI-targetsEfficiently and competently implement ISO13485 & MDD & MDR...

  • Lead Auditor

    6 days ago


    New York, United States X4 Life Sciences Full time

    A lead Notified Body client of X4 Life Sciences is looking to add a Lead Auditor for Medical Devices to it's rapidly growing, dynamic team.About The RoleThis role is for medical device certification. The main responsibilities of this role are:Responsibility for achieving his/her own KPI-targetsEfficiently and competently implement ISO13485 & MDD & MDR...

  • Lead Auditor

    6 days ago


    New York, United States X4 Life Sciences Full time

    A lead Notified Body client of X4 Life Sciences is looking to add a Lead Auditor for Medical Devices to it's rapidly growing, dynamic team.About The RoleThis role is for medical device certification. The main responsibilities of this role are:Responsibility for achieving his/her own KPI-targetsEfficiently and competently implement ISO13485 & MDD & MDR...

  • Compliance Auditor

    3 weeks ago


    New York, United States RPMGlobal Full time

    Review data, such as billing, coding, financial, and medical record documentation to determine compliance with applicable regulations, policies, and requirements. Assist with internal audits and regulatory risk assessments. Research, interpret and communicate federal and state laws and guidelines pertaining to Medicare and Medicaid to relevant parties. Plan...


  • New York, United States Insight Global Full time

    Required Skills & Experience 7-12 years of professional work experienceExperience using Java or Python to conduct code reviewsExperience working in risk and controls in the financial industryExperience doing execution testing and attribute testing specifically in change managementExcellent verbal and written communication skills to write work papers Nice to...