Outpatient Medical Documentation Auditor

July 24, 2024

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HYRE HARPER Co.

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HYRE HARPER Co. is a company that revolutionizes government contract opportunities through project management and talent acquisition, leveraging military-honed expertise. They streamline tedious tasks, enhance decision-making speed, ensure compliance, and improve process efficiency by providing tailored solutions to meet the unique goals and limitations of various organizations.

government contracting

2 - 10 employees

Founded 2023

🏛️ Government

🤝 B2B

👥 HR Tech

📋 Description

• The Medical Documentation Auditor ensures accurate and complete documentation through compliance and encounter audits and clinician feedback. • Provides documentation feedback to clinicians from E&M, CPT, and ICD9 audits conducted using all state/federal and third-party payor regulatory standards for outpatient groups. • Conduct concurrent and retrospective audits of documentation supporting E/M, CPT, and ICD9 codes assigned by clinical staff. • Research correct coding practices in relation to applicable rules, regulations, and coding conventions for billing to determine compliance with Federal, State, and third-party payor regulations. • Review audit findings with individual physicians, making suggestions for documentation improvements. • Provide feedback to clinicians based on Federal and State government billing and coding guidelines. • Plan, schedule, and perform comprehensive chart audits to identify operational and regulatory issues related to coding, documentation, and compliance requirements. • Ensure complete and accurate data capture in compliance with Federal and State requirements. • Design and implement methodologies to ensure accurate and complete E&M, CPT, and ICD9 coding audits. • Provide technical expertise to leadership to identify and resolve coding and chart documentation problems impacting the accuracy and consistency of coded data. • Work with Trainers to address operational processes that hinder encounter data capture. • Enter audit results into audit tools to support quality assurance processes, analysis, and training activities. • Review analytical data and audit findings to identify coding trends and other risk areas and recommend appropriate actions. • Conduct quality assurance reviews and collaborate in the development and execution of audit and training plans. • Assist in developing and implementing policies and procedures to ensure compliance with Federal, State, and other regulatory requirements.

🎯 Requirements

• Minimum three (3) years CPT, ICD9, and E&M Coding experience. • Bachelor's degree in business administration, health care, public health, finance, business medical records technology, or four (4) years of experience in a related field. • High School Diploma or General Education Development (GED) required. • Certification as a Certified Coding Specialist, Certified Professional Coder - Hospital Outpatient, Registered Health Information Administrator, Registered Health Information Technician, or Certified Professional Coder. • Proficient in the use of PC applications such as MS Word, Excel, Access, and PowerPoint. • Experience conducting Medical Record audits and interpreting and applying Federal and State regulations, coding, and billing requirements. • Comprehensive knowledge of medical diagnostic and procedural terminology. • Ability to provide constructive and sensitive feedback to providers and leadership regarding federal and state coding, medical documentation, and compliance guidelines. • Ability to work with and maintain confidentiality of physician, patient, patient account, and personnel data. • Knowledge of outpatient coding practices. • Strong interpersonal, written, verbal, and presentation skills. • Ability to work independently with minimal supervision, prioritize workload, and meet deadlines. • Ability to read and interpret medical data. • Willingness to be flexible depending upon department and/or physician schedule needs. • Experience using electronic health record systems and web-based applications preferred.