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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 dynamic management services organization specializing in revenue cycle management for various surgical practices. We are currently seeking a dedicated Medical Coding Auditor to perform quality assessments of clinical and non-clinical coding practices. The ideal candidate will be proactive, results-oriented, and committed to enhancing process efficiency, continuous improvement, and the education of our healthcare providers and staff regarding 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 accuracy is consistently monitored, and educational resources are provided based on the findings from coding assessments.

3. Generate detailed reports for management review, highlighting trends and areas for improvement.

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

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

Qualifications:

1. Strong understanding of Evaluation and Management as well as surgical coding principles and guidelines.

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

3. A minimum of two years of experience in professional inpatient and outpatient medical auditing is required.

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

Requirements:

1. CPC or CCS-P certification is mandatory.

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

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

4. A high school diploma is required.

Essential Skills:

1. Proficient in PC operations.

2. Excellent written and verbal communication skills along with strong 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 to changing priorities.

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

6. Comprehensive knowledge of medical terminology, anatomy, and physiology, with the ability to accept direction effectively.

Supervisory Responsibilities:

Number of Employees Supervised: 0