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Medical Coding Quality Auditor

2 months ago

Jacksonville, Florida, United States North Florida Surgeons Full time
Job Overview

North Florida Surgeons is a dynamic management services organization dedicated to providing exceptional revenue cycle solutions for various surgical practices. We are currently seeking a Coding Auditor to perform quality assessments of both clinical and non-clinical coding professionals. The ideal candidate will be a motivated and detail-oriented auditor who is committed to enhancing process efficiency, fostering continuous improvement, and educating our healthcare providers and staff on coding standards.

Key Responsibilities

1. Collaborate with the Coding and Compliance Manager to plan and execute targeted retrospective quality assessments of physicians, mid-level providers, and both internal and external coding staff.

2. Partner with the Coding and Compliance Manager to ensure that coding accuracy is consistently monitored, and training is provided based on the outcomes of the coding evaluations.

3. Generate comprehensive reports for management review, identifying trends and areas for improvement.

4. Conduct reviews in a timely and systematic manner, compiling results and delivering feedback to relevant personnel.

5. Assist the Coding and Compliance Manager in creating educational materials for all staff regarding annual updates on diagnosis and procedural coding, documentation tips, and coding guidelines as necessary.

Qualifications

1. A solid understanding of Evaluation and Management as well as surgical coding and relevant guidelines is essential.

2. Experience in professional inpatient and outpatient medical coding and billing is required.

3. A minimum of two years of experience in professional medical auditing for both inpatient and outpatient settings is necessary.

4. For the Senior Coding Quality Auditor role, a minimum of three years of professional medical auditing experience is required.

Requirements

1. CPC or CCS-P certification is mandatory.

2. The CPMA credential must be obtained within the first year of employment; Senior Coding Quality Auditors must already possess this credential.

3. An Associate's or Bachelor's degree in a healthcare-related field is preferred but not mandatory.

4. A high school diploma is required.

Essential Skills

1. Proficient in PC usage.

2. Strong written and verbal communication skills along with excellent customer service abilities.

3. Proficiency in Microsoft Windows Operating Systems and Office applications, including Word, Excel, PowerPoint, and coding/grouping software.

4. Detail-oriented, organized, and adaptable.

5. Ability to demonstrate initiative and meet minimum productivity standards.

6. Comprehensive knowledge of medical terminology, anatomy, and physiology, with the ability to adapt to changing priorities.

Supervisory Responsibilities

No direct supervisory responsibilities.