Physician Audit-educator
3 weeks ago
POSITION SUMMARY Monitoring Provider documentation by performing prospective and retrospective audits of patients# charts to ensure compliance with all applicable federal, state and local regulations, as well as with institutional/organizational standards, practices, policies and procedures. Provides coding and documentation support through one on one visits, phone calls and WebEx along with the creation of specialty or individual provider tip sheets. Provides guidance and advice for reporting policies mandated by government entities and other payers for completion of accurate documentation to support the level of service, diagnosis, procedure and diagnostic code assignments. Respond to payor audits conducted by the CMS RAC contractor, Medicare, Medicaid, as well as all other payors. Analyzes data, communicates findings, and facilitates improvement efforts with the provider. Independently and/or department collaboration in developing and maintaining educational materials and training programs. May consider remote employee. MINIMUM QUALIFICATIONS AND REQUIREMENTS Licenses and Certifications Required Certification as a Professional Coder (CPC) or Certified Evaluation and Management Coder (CEMC) from the American Academy of Professional Coders (AAPC), or Certification as a Clinical Coding Specialist Physician (CCS-P) through American Health Information Management Association. Educational Requirements Associates Degree preferred Experience Requirements Three (3) years of professional fee coding/auditing experience Special Skills or Training Requirements Demonstrated advanced communication and interpersonal skills Excellent written and oral communication skills Self-directed, attention to detail, proficient in Microsoft Office Suite applications including Outlook, Word and Excel
* POSITION SUMMARY
* Monitoring Provider documentation by performing prospective and retrospective audits of patients' charts to ensure compliance with all applicable federal, state and local regulations, as well as with institutional/organizational standards, practices, policies and procedures. Provides coding and documentation support through one on one visits, phone calls and WebEx along with the creation of specialty or individual provider tip sheets. Provides guidance and advice for reporting policies mandated by government entities and other payers for completion of accurate documentation to support the level of service, diagnosis, procedure and diagnostic code assignments. Respond to payor audits conducted by the CMS RAC contractor, Medicare, Medicaid, as well as all other payors. Analyzes data, communicates findings, and facilitates improvement efforts with the provider. Independently and/or department collaboration in developing and maintaining educational materials and training programs. May consider remote employee.
* MINIMUM QUALIFICATIONS AND REQUIREMENTS
* Licenses and Certifications Required
* Certification as a Professional Coder (CPC) or Certified Evaluation and Management Coder (CEMC) from the American Academy of Professional Coders (AAPC), or Certification as a Clinical Coding Specialist Physician (CCS-P) through American Health Information Management Association.
* Educational Requirements
* Associates Degree preferred
* Experience Requirements
* Three (3) years of professional fee coding/auditing experience
* Special Skills or Training Requirements
* Demonstrated advanced communication and interpersonal skills
* Excellent written and oral communication skills
* Self-directed, attention to detail, proficient in Microsoft Office Suite applications including Outlook, Word and Excel
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