Outpatient Medical Documentation Auditor - Full-timeRemote

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