Senior Compliance Coding Auditor

4 weeks ago


Austin, United States ComplianceWise Full time

Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Identify coding discrepancies and formulate suggestions for improvement. Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas. Work with the Office of the CMO and provider leadership to identify and assist providers with coding. Report findings and recommendations to Compliance Officer or designee, management, and executive leadership. Provide continuing education to providers and ancillary staff on CDT, CPT, HCPCS, and ICD-10 coding. Support compliance policies with government (Medicare& Medicaid) and private payer regulations. Perform research as needed to ensure organizational compliance with all applicable coding and diagnostic guidelines. Maintain professional and technical knowledge by attending educational workshops and reviewing professional publications. Work closely with all departments, including but not limited to, Clinical Services, Nursing, Practice Leadership, Finance, IT, Training, and Billing to assist in accuracy of reported services and with chart reviews, as requested. Work with the Purchasing department to order and distribute annual coding materials for all clinical sites and departments. Assist Director of Compliance with incidents and investigations involving coding and/or documentation. Work closely with all other Compliance personnel to provide coding/compliance support. Advise Compliance Officer or designee of government coding and billing guidelines and regulatory updates. Provide training to billing coding staff on coding compliance. Participate in special projects and performs other duties as assigned. #J-18808-Ljbffr



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