General Summary :
Responsible for reviewing, analyzing, disseminating and reporting data on chart audits as well as audit documentation requirements of services billed per pre-established criteria approved by the Director of Compliance and the Quality and Compliance Committee.
Works under the Supervision of the Quality and Compliance Director
Principal Duties & Responsibilities :
Example of Essential Duties :
Audit medical records for data collection and format, coding documentation and content utilizing pre-established criteria.
Meets with physicians to review audit results and makes needed recommendations.
- Audit medical record for adherence to Toledo Clinic Electronic Medical Record policies and procedures, documentation of quality measures, treatment plans, patient follow-up, as well as federal and insurance guidelines.
- Performs educational sessions with physicians as needed.
- Creates educational programs for physicians and coding staff to maintain compliance education.
- Maintain written or computerized log of all data collected.
- Assist in collating, analyzing, and preparation of written report for the
Compliance Program under the direction of the manager(s).
- Assist and / or perform these audits on main campus and satellite locations.
- Monitors and retains Internal Compliance accountability logs.
Other Essential Duties May Include (but are not limited to) :
- Assist with special projects / audits and / or education as requested.
- Other duties as assigned.
Knowledge, Skills & Abilities Required :
Required :
- Minimum 5 years experience in Coding, Billing, and Auditing.
- Knowledge of computer software, HTML forms design, data base spreadsheets, and word processing.
- Knowledge of medical records policies and procedures.
- Knowledge of medical terminology.
- Requires travel during business hours, valid state drivers license preferred.
- Consistently arrives at work, in professional attire, on time and completes all tasks within established time frame.
- Seeks appropriate tasks when primary tasks are completed and assists co-workers as needed.
- Demonstrates adaptability to expanded roles.
- Adheres to clinic policies and procedures.
Education :
Diploma, certificate, or degree in medical coding preferred.
Preferred :
- CPC Certification helpful
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