Medical Record Audit

Department/Unit: Health Information Management Work Shift: Day (United States of America) Salary Range: $60,367.47
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- $90,551.20 Professional Coding Auditor will apply an advanced professional coding skill set to act as a service line coding team lead expert, working collaboratively to support all workflows related to professional fee coding/charging/denials follow-up.
Coordinates with others as needed to ensure comprehensive and timely completion of professional coding processes.
Audit CPT and ICD-10 diagnosis coding applied by providers and coding staff to assure compliance with federal and state regulations and insurance carrier guidelines.
Provide education, instruction and training to providers and coding staff.
This position is remote but does require onsite education to providers as needed.
This position has remote opportunity This position requires a CPC Certification
- Upon Hire Two years or more prior experience in professional fee coding
- Ensuring established productivity and quality standards are met.
Complex coding skill set required to act as service line expert.
Assist Supervisor in the daily operations of coding team(s) in a Team Lead position, ensuring staff are meeting established coding/charge processing productivity and quality standards.
Assume supervisory tasks for the assigned coding staff in absence of Supervisor.
Define and submit coding/edit rules for consideration to streamline coding accuracy and efficiency within multiple interfaced systems.
Participate as a workflow expert in all levels of application testing to include test script building, script processing through varying test systems, charge import into applicable systems and detailed review of accuracy for each process.
Assist with the implementation, testing, troubleshooting and maintenance of third-party vendor applications software.
Orient and train, provide feedback, and evaluate the staff as needed.
Perform System Manager tasks for specified applications in his/her absence to include: compile and create daily reports, Import charges into applicable systems.
Research/correct coding validation errors during charge import.
Assist in creating and updating policies and procedures to include system development and maintenance documentation.
Conducts professional fee billing integrity reviews/audits for AMHS, including reviewing medical record documentation and coding to assess compliance with related rules and regulatory requirements, and to identify clinical documentation improvement opportunities.
Identify trends based on audit/review findings and formulate recommendations for follow-up education and corrective actions.
Effectively communicate and educate relevant parties with the results of review/audit activity; and help with development of related action plans.
Assist with Denials Management to determine root causes and provide feedback and training to providers/staff to reduce denials.
Acts as a liaison for external audits and organizes the process.
Qualifications High School Diploma/G.required Two years or more prior experience in professional fee coding
- required Knowledge of multiple coding specialties.
- preferred Working knowledge and experience with provider professional fee coding and charge processing.
Complex coding skill set required.
Computer experience, windows environment with proficiency in Microsoft Word and Excel is required.
Thank you for your interest in Albany Medical Center Albany Medical is an equal opportunity employer.
This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes.
Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.
Remote working/work at home options are available for this role.