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Physician Compliance Auditor

4 months ago

Marquette MI United States UP Health System - Marquette Full time

UP Health System - Marquette

Physician Compliance Auditor, Central Billing Office, 1.0DV


Who We Are:
People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. UPHS Marquette is a 222 bed hospital and houses the regions only Level II Trauma Center and Neonatal Intensive Care Unit (NICU). We also provide outreach with programs like annual health and safety fairs, health screenings for the entire family and more to keep our community healthy


Where We Are:
In Marquette our fascinating history, rural landscape, abundant recreational opportunities, and welcoming people make the Upper Peninsula someplace special. From a thriving culinary scene to charming shops to historic lighthouses and museums, there is something for everyone in this beautiful lakeside gem.


Why Choose Us:
Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
Competitive Paid Time Off / Extended Illness Bank package for full-time employees
Employee Assistance Program mental, physical, and financial wellness assistance
Tuition Reimbursement/Assistance for qualified applicants
Opportunities for education and training through partnership with Duke LifePoint Healthcare
And much more


Position Summary:

Monitors, consults, educates, audits and performs trend coding decision making.

Reports to: Director

FLSA: Exempt

ESSENTIAL FUNCTIONS:

Responsible for reviewing and maintaining pertinent regulations and policies, ensuring all data elements are accurate and comply with all payor requirements.
DragEditDeleteProvide Onboarding education to all new providers.DragEditDeleteProvides education regarding documentation requirements to improve coding quality and ensure accurate and complete capture of maximum revenue.
DragEditDeleteWork closely with the RCS (Regional Coding Specialist) program (HSC)DragEditDeleteSystem Administrator for Systems Intergy and Ingenious Med
DragEditDeleteReviews and interprets various regulatory billing and coding updates, to remain compliant and accurate and to minimize noncompliance.
DragEditDeleteEnsure accuracy of the EHRs and any new systems as they are implementedDragEditDeleteWork closely with Finance, Medical Records, and other revenue producing areas or departments to assure accuracy and compliance to acceptable billing/coding guidelines and regulations

Minimum Qualifications:

Minimum Education
High school diploma or equivalent
*Years of relevant experience may be substituted for required education.DragEditDeleteRequired Skills
Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.DragEditDeleteRequired Skills
Must have thorough understanding of ICD-10 Official Coding Guidelines for Coding and Reporting; HCPCS/CPT coding systems and CPT Assistant and Coding Clinic for HCPCS guidelines.DragEditDeleteRequired Skills
Certifications: (one of the following)
Certified Professional Coder (CPC)
Certified Evaluation and Management Coder (CEMC)
Certified Professional Medical Auditor (CPMA)DragEditDeleteMinimum Work Experience
5 years related experience


EEOC Statement:
UP Health System Marquette is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.


Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran
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