IP / OP Auditor

Job Description

Job Description

Description :

Facility IP / OP Auditor - per diem

Are you interested in joining one of the nation's leading providers of medical coding services that is experiencing impressive year-over-year growth? Here is your opportunity to be part of this exciting team. We are hiring now and have an immediate need for an Inpatient / Outpatient Auditor.

Part time role - 20 hours a week

• Develops and provides on-going training / education to support application and adoption of ICD-10-CM / PCS coding and documentation concepts for internal and external coders.
• Auditing –IP Audits to include : ICD-10-CM / PCS, and HCPCs Level I and II codes, including specific focused audits, custom audits, and general application audits. All audit processes include responsibility for coordinating and managing timeline of deliverables to customer.
• Auditing -OP Audits to include : Responsible for accurate data entry into the Audit tool, if applicable. Responsible for review of all medical record documentation in order to validate correct reporting of services provided. Responsible for validating complete physician order for all outpatient services. The components of a complete physician order include diagnosis / diagnoses ; date and time order was written / entered; specification of service to be provided, valid physician authentication including date and time order was authenticated. Responsible for validating that service ordered was provided and billed with appropriate HCPCS code(s).
• Validating accuracy and completeness of all medical record documentation; validating that service was ordered, provided and reported with appropriate code(s); all data elements transferred from the charge entry and coding process through the billing system and the payor’s claim processing system, including validation that appropriate payment was received by the client upon adjudication of the claim.
• Provides, if required, continuing education to internal and external clients regarding changes to coding and reimbursement systems.
• Other duties as assigned

Requirements :

Minimum of 3 years Inpatient and Outpatient Facility auditing experience (recent)