This is a remoteposition.
JobSummary :
The MedicalDocumentation Auditor ensures accurate and complete documentationthrough compliance and encounter audits and clinician feedback.
Provides documentation feedback to clinicians from E&M CPTand ICD9 audits conducted using all state / federal and thirdpartypayor regulatory standards for outpatientgroups.
EssentialResponsibilities :
CoreAudit Responsibilities :
- Conduct concurrent and retrospective audits ofdocumentation supporting E / M CPT and ICD9 codes assigned byclinical staff.
- Research correctcoding practices in relation to applicable rules regulations andcoding conventions for billing to determine compliance with FederalState and thirdparty payor regulations.
- Review audit findings with individual physicians makingsuggestions for documentation improvements.
- Provide feedback to clinicians based on Federal and Stategovernment billing and coding guidelines.
- Plan schedule and perform comprehensive chart audits toidentify operational and regulatory issues related to codingdocumentation and compliance requirements.
- Ensure complete and accurate data capture in compliancewith Federal and State requirements.
- Design and implement methodologies to ensure accurate andcomplete E&M CPT and ICD9 codingaudits.
- Provide technical expertiseto leadership to identify and resolve coding and chartdocumentation problems impacting the accuracy and consistency ofcoded data.
- Work with Trainers toaddress operational processes that hinder encounter datacapture.
- Enter audit results intoaudit tools to support quality assurance processes analysis andtraining activities.
- Reviewanalytical data and audit findings to identify coding trends andother risk areas and recommend appropriateactions.
- Conduct quality assurancereviews and collaborate in the development and execution of auditand training plans.
- Assist indeveloping and implementing policies and procedures to ensurecompliance with Federal State and other regulatoryrequirements.
Requirements
Qualifications :
- Minimum three (3) years CPT ICD9 andE&M Coding experience.
- Bachelors degree in business administration health carepublic 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 aCertified Coding Specialist Certified Professional Coder HospitalOutpatient Registered Health Information Administrator RegisteredHealth Information Technician or Certified ProfessionalCoder.
- Proficient in the use of PCapplications such as MS Word Excel Access andPowerPoint.
- Experience conductingMedical Record audits and interpreting and applying Federal andState regulations coding and billingrequirements.
- Comprehensiveknowledge of medical diagnostic and proceduralterminology.
- Ability to provideconstructive and sensitive feedback to providers and leadershipregarding federal and state coding medical documentation andcompliance guidelines.
- Ability towork with and maintain confidentiality of physician patient patientaccount and personnel data.
- Knowledge of outpatient codingpractices.
- Strong interpersonalwritten verbal and presentation skills.
- Ability to work independently with minimal supervisionprioritize workload and meet deadlines.
- Ability to read and interpret medicaldata.
- Willingness to be flexibledepending upon department and / or physician scheduleneeds.
- Experience using electronichealth record systems and webbased applicationspreferred.
Inpatient Medical Auditor
30+ days ago