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Coding Audit

1 month ago

South Portland, United States MaineHealth Full time

Summary

  • Position Summary

  • ***This is a FT hybrid position working both remote and onsite, with flexibility to meet educational and organizational needs.

    The Provider Audit & Education Auditor/Educator Specialist position is chiefly responsible for the core elements of compliance related to professional medical chart auditing and educating physicians, APPs, and other supporting providers and ancillary staff in multi-specialty settings across the MHMG. The Auditor/Educator Specialist reports to the Operations Compliance Manager, following onboarding training with the Education Compliance Manager. The Auditor/Educator Specialist reviews professional encounter note for accuracy; level of service coding, diagnostic coding; as well as other relevant, non-clinical, compliance elements and subsequently furnishes education. Specialists meet personally with new hires to furnish providers with onboarding training education to establish a strong foundation of communication, rapport, and coding education and compliance knowledge. Continued education is furnished to providers throughout the year and annually as regulations and rules change. Responds promptly to coding inquiries from providers or others with precise and accurate results, as well as the ability to research and interpret regulations and coding changes. The Auditor/Educator Specialist should possess the ability to work independently as well as in a group setting. Maintaining coding compliance education and relevant certifications required.

    Required Minimum Knowledge, Skills, and Abilities (KSAs)

    • Education: High school diploma or equivalent preferred.
    • License/Certifications: Certified Professional Coder; CPC, CCS or CCS-P. (Or obtained within 6 months of hire.) (CMPA, not required, but preferred)
    • Experience: Minimum 3 years' related experience.
    • Working knowledge of CPT and ICD-10 coding.

    • Knowledge of coding policies and billing practices.
    • Ability to read, interpret medical charts and perform a coding audit.
    • Excellent organizational skills with the ability to accomplish multiple tasks.
    • Excellent communication, customer service, and interpersonal skills with the ability to communicate clearly in person, in writing, and on the phone.
    • Proficient computer skills to include Excel, Word, and PowerPoint, Teams/Zoom Meetings.
    • Ability to maintain confidentiality.
    • Ability to work independently and as a team member with minimal direct supervision.
    • Ability to maintain a professional manner at all times.
    • HCC/Risk Diagnostic Coding knowledge preferred.