Physician Audit and Education Manager

April 3

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MedKoder, LLC

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MedKoder, LLC is a full-service medical coding management company specializing in providing expert medical coding services across all physician service lines, including inpatient and outpatient facility coding. The company also focuses on medical risk adjustment management and offers services for clinical documentation improvement, revenue integrity, and revenue cycle consulting. MedKoder utilizes proprietary technology, including Artificial Intelligence, Automated Business Intelligence, and Natural Language Processing, to automate coding processes and improve efficiency. Their customized tools and workflows are built in-house, providing clients with reduced costs and superior results in medical risk adjustment and clinical documentation improvement for Medicare Advantage, ACA, and Medicaid programs.

Coding Audit & Consulting • Clinical Documentation Improvement • DRG Management • Inpatient Coding • Outpatient Coding

51 - 200 employees

⚕️ Healthcare Insurance

☁️ SaaS

🤖 Artificial Intelligence

📋 Description

• Under the direction of the Director of Physician Coding, the Audit and Education Manager is responsible for leading and maintaining the Auditing and Education team • This role involves overseeing the daily operations of assigned clients, managing staff, analyzing data, and ensuring goals align with organizational objectives • The Manager provides leadership to a team of auditors and educators, fostering growth, compliance, and quality in client engagements • This position also serves as a client advocate, ensuring services are delivered in alignment with contract terms and evolving client needs • Manage a team of auditors/educators ensuring adequate staffing levels, quality and productivity reviews, and conducting performance evaluations • Develop and maintain audit and education schedules, workflows, and trackers • Meet with clients to plan audits and provide education on audit results regarding accurate coding and best practices • Attend meetings and deliver presentations to providers, clients, and company executives • Communicate client goals and requirements to the team to ensure proper execution • Regularly review client project goal templates and address concerns with proactive communication • Ensure project deliverables adhere to internal quality standards • Develop and deliver coding training programs for staff and clients • Provide ongoing education to team and clients on coding updates, compliance issues, and best practices • Address individual errors through targeted coaching • Conduct professional audits across multiple specialties and settings, including E&M and surgical cases • Conduct regular meetings with the Coding Director and Team Leads • Collaborate with the Coding Director to identify opportunities for efficiencies • Collaborate with the Business Development team to support client growth and retention, as well as onboarding new clients • Stay updated on coding guidelines and changes (ICD-10-CM, CPT, HCPCS, AMA, CMS, AHA Coding Clinics, HHS/OIG) • Ensure coding compliance with industry standards and payer requirements • Address discrepancies and adherence to Local Coverage Determination (LCDs) and National Coverage Determination (NCDs) • Generate reports on compliance metrics and audit findings • Analyze data trends and implement corrective actions • Provide customized reports and summaries to leadership as needed

🎯 Requirements

• High School diploma required • Associate or BS degree in the healthcare field preferred • Successful completion of at least one AHIMA or AAPC certified program with the achievement of the correlating professional credential (CCS, CPC, etc.); active and in good standing • Successful completion of the AAPC CPMA credential is required; preferably a combination of two or more credentials • Minimum 8 years of recent physician coding experience and 5 years of recent physician auditing experience are required • Minimum 3 years of management or supervisory experience in this field preferred • Experience educating providers one-on-one or in group settings • Experience creating and implementing audit plans • Must have a professional demeanor and exceptional communication skills (verbal and written) • Must be a subject matter expert on E&M and Surgical coding • Must have expert knowledge of medical terminology, anatomy and physiology, disease processes, CPT coding and guidelines by the AMA, ICD-10-CM coding and guidelines, and Medicare and Medicaid billing policies for professional services • Additional skills required: Proficiency with Microsoft Word, Excel, PowerPoint, Windows, and healthcare information and billing systems

🏖️ Benefits

• Up to 100% EMPLOYER PAID Medical, Dental, and Vision benefits for employees • 401K and Profit Sharing • STD, LTD, Life Insurance, and FSA Program • Paid AAPC and AHIMA corporate memberships • 30 Hours of CEU pay (continuance in education) • Generous paid time off, holiday pay, and flexible scheduling year-round