Coding Auditor - Outpatient

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Revenue Cycle Management • Business Intelligence • Revenue Recovery • Managed Care Improvement • Physician Advisor Services

1001 - 5000

💰 Private Equity Round on 2021-09

Description

• The Coding Auditor will be responsible for outpatient coding and auditing for various specialties • This role will also be responsible for preparing and presenting audit results • Perform coding audits and compliance audits for providers, including physicians and mid-level providers • Prepare reports of audits and present audits to internal and external parties as needed • Complete accurate application of appropriate coding and documentation guidelines, including but not limited to, E&M and surgery documentation guidelines, CCI guidelines, CPT/HCPCS coding guidelines, and specialty association guidance • Provide physician education when necessary • Complete coding audits for copartners’ coding WQ • Work with any offsite auditors • Evaluate and report on the overall quality of physician documentation that supports selected codes most specifically but not inclusive of medical necessity • Adhere to local and national coverage determinations, and CCI and payer specific editing rules • Ensure appropriate documentation and coding of split/shared services, teaching physician guidelines and any client specific quality assessment programs • Compile, trend, analyze and report on all findings that do not meet all of the guidelines listed above • Maintain a professional attitude • Other duties as assigned by the management team • Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

Requirements

• High School diploma or equivalent required • CPC or CCS coding certification required from AHIMA or AAPC • Minimum 5 years of coding experience and minimum 2 years auditing experience in a multi-specialty setting • Knowledge of Microsoft Word, Outlook, Excel • Must be able to use job-related software • Self-starter with ability to work independently