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Healthcare Coding Quality Auditor

2 months ago

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

North Florida Surgeons is a prominent management services organization dedicated to providing comprehensive revenue cycle solutions for various surgical practices. We are currently seeking a Medical Coding Auditor to perform thorough quality assessments of both clinical and non-clinical coding professionals. The ideal candidate will be a proactive and results-oriented auditor who is committed to enhancing process efficiency, fostering continuous improvement, and educating our 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 personnel.

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

3. Generate detailed reports for management review and identify emerging trends in coding practices.

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 coding as well as surgical coding and its 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 inpatient and outpatient medical auditing is necessary.

4. For the Senior Coding Quality Auditor role, a minimum of three years of professional 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 operations.

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

3. Proficiency in Microsoft Windows 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

Number of Employees Supervised: 0