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Compliance coding Auditor

4 months ago

Toledo, United States Toledo Clinic Full time
General Summary

Responsible for reviewing, analyzing, disseminating and reporting data on chart audits as well as audit documentation requirements of services billed per pre-established criteria approved by the Director of Compliance and the Quality and Compliance Committee.

Works under the Supervision of the Quality and Compliance Director

Principal Duties & Responsibilities:

Example of Essential Duties
  • Audit medical records for data collection and format, coding documentation and content utilizing pre-established criteria. Meets with physicians to review audit results and makes needed recommendations.
  • Audit medical record for adherence to Toledo Clinic Electronic Medical Record policies and procedures, documentation of quality measures, treatment plans, patient follow-up, as well as federal and insurance guidelines.
  • Performs educational sessions with physicians as needed.
  • Creates educational programs for physicians and coding staff to maintain compliance education.
  • Maintain written or computerized log of all data collected.
  • Assist in collating, analyzing, and preparation of written report for the

Compliance Program under the direction of the manager(s).

  • Assist and/or perform these audits on main campus and satellite locations.
  • Monitors and retains Internal Compliance accountability logs.

Other Essential Duties May Include (but are not limited to):

  • Assist with special projects/audits and/or education as requested.
  • Other duties as assigned.

Knowledge, Skills & Abilities Required:

Required
  • Minimum 5 years experience in Coding, Billing, and Auditing.
  • Knowledge of computer software, HTML forms design, data base spreadsheets, and word processing.
  • Knowledge of medical records policies and procedures.
  • Knowledge of medical terminology.
  • Requires travel during business hours, valid state drivers license preferred.
  • Consistently arrives at work, in professional attire, on time and completes all tasks within established time frame.
  • Seeks appropriate tasks when primary tasks are completed and assists co-workers as needed.
  • Demonstrates adaptability to expanded roles.
  • Adheres to clinic policies and procedures.
Education
  • Diploma, certificate, or degree in medical coding preferred.
Preferred
  • CPC Certification helpful