Coding & Compliance Auditor

Location:

Pay Range:

Position Summary:

Responsible for performing E/M audits, summarizing the results, communicating the outcomes to all parties and completing any follow up or educational needs as required. Responsible for the review and completion of email requests in a timely manner as well as reviewing and completing ticket requests. Assigned list review and update in a timely and accurate manner. Contributes to the completion of government audits when requested.

Key Performance Areas:

• Provide coding support for physicians.

• Provide coding support for Claims Resolution Specialists. Meet with Manager to discuss coding trends and report any coding issues.

• Attend seminars and training sessions and report any changes or concerns to Manager/Compliance Officer.

• Maintain and ensure the confidentiality of all patient and employee information at all times.

• Assist in training new employees to related job duties.

• Will be expected to work overtime when given sufficient notice of required overtime.

• Comply with all Federal and State laws and regulations pertaining to patient care, patients’ rights, safety, billing, and collections. Adhere to all Company and departmental policies and procedures, including IT policies and procedures and Disaster Recovery Plan.

• Maintain all company equipment in safe and working order.

• Complete E/M audits accurately in a timely manner as assigned to the Auditor Queue. Audit Request (Compliance and other departments)

• Contribute to the review and completion of tickets, emails and/or lists as assigned in a timely and accurate manner.

• Contribute to the updating of Training Manuals, PowerPoints and SOP’s as well as work with peers while they are learning all the required duties of Coding Audits. Provide Physician and extender training as needed.

• Proficient in the use of the required programs to accomplish assigned work task and follow up as needed. This includes but not limited to Excel, word, Outlook, and SharePoint.

• Contribute to Government Audit Request as needed.

• Performs other duties and projects as assigned.

Required Qualifications:

2 + years coding experience with E/M experience in a medical office preferred

CPC and/or CCS (Other AHIMA and/or AAPC certifications could be considered)

Core Capabilities:

• Analysis & Critical Thinking: Critical thinking skills including solid problem solving, analysis, decision-making, planning, time management and organizational skills. Must be detailed oriented with the ability to exercise independent judgment.

• Interpersonal Effectiveness: Developed interpersonal skills, emotional intelligence, diplomacy, tact, conflict management, delegation skills, and diversity awareness. Ability to work effectively with sensitive and confidential material and sometimes emotionally charged matters.

• Communication Skills: Good command of the English language. Second language is an asset but not required. Effective communication skills (oral, written, presentation) is an active listener, and effectively provides balanced feedback.

• Customer Service & Organizational Awareness: Strong customer focus. Ability to build an engaging culture of quality, performance effectiveness and operational excellence through best practices, strong business and political acumen, collaboration and partnerships, as well as a positive employee, physician and community relations.

• Self-Management: Effectively manages own time, conflicting priorities, self, stress, and professional development. Self-motivated and self-starter with ability to work independently with limited supervision.

• Must be able to work effectively in a fast-paced, multi-site environment with demonstrated ability to juggle competing priorities and demands from a variety of stakeholders and sites.

• Computer Skills:

  • Proficiency in MS Office Word, Excel, Power Point, and Outlook required