Remote Coding Auditor
Employer:
Edelberg and Associates
Category:
Auditor/Coding
Location:
Remote
Availability:
Full time or part time
Date Posted:
6-24-24
Position Summary:
Experience Free Standing, Urgent care, ED Professional and Facility Auditor
Under the direction of Compliance and Coding Management, the Medical Auditor is responsible for performing focused coding quality reviews to validate the integrity of code assignments by Coding Specialists for E/M levels, CPT procedures, modifiers, HCPCS codes and ICD-10 codes according to medical chart documentation. The Auditor will document and report to management relevant coding and provider documentation trends including areas that are high risk for potential compliance concerns. The Auditor is responsible for offering recommendations for improvement to maintain a minimum of 95% coding quality across the department. The Auditor ensures billing optimization and minimizes errors by identifying opportunities during review and audit. The Auditor will assist with special projects as needed. The Auditor is responsible for maintaining current coding regulatory and procedure changes which may affect coding compliance and reimbursement.
Education/Experience:
Minimum of 5 years coding experience mandatory with a minimum of 2 years of auditing experience preferred.
License/Certification:
CPC or CCS/CCS-P (Required)
CPMA (Required)
Knowledge:
Requires excellent and comprehensive knowledge of Anatomy, Physiology, and all body systems. Strong background knowledge of disease process and Pharmacology. Knowledge of Outpatient coding quality programs and payer models, including but not limited to CMS, all applicable edits which includes NCCI and NCD/LCD edits and the accuracy of coded data impacting reimbursement and external quality databases. Must show competency in ICD-10 CM, CPT, modifiers and HCPCS coding. Must possess and demonstrate coding and auditing expertise. Requires in-depth knowledge of clinical coding processing and documentation standards, guidelines, policies, and procedures.
Skills:
Must be proficient with Microsoft Word, Excel, Power Point and Outlook. Must be conversant in clinical documentation improvement and a high level of proficiency in training. Ability to navigate various and multiple EMR systems. Must be able to read and interpret electronic and manual documentation generated by healthcare professionals. Ability to work independently.
Requires analytical ability to interpret clinical data to determine appropriate codes supported by documentation, ICD-10 CM and CPT coding classification systems. Requires excellent written, oral communication and interpersonal skills. The ability to effectively communicate with management staff, coding professionals and administrative support staff in a professional manner is essential. Requires the ability to provide constructive feedback for the development of coding staff. Must demonstrate knowledge of and experience with coding and auditing of outpatient medical records. Must be able to interpret acuity, payor, documentation deficiencies and trending report data and recommend improvement opportunities. Ability to review code denials and system scrubbers for resolution. Ability to prioritize, manage time efficiently, follow through on completion of responsibilities and work independently.
Job Type: Full-time / Part time
Schedule:
Monday to Friday, but flexible for weekends
Work Location: Remote
Job Types: Full-time, Part-time
Pay: $30.00 - $35.00 per hour
Schedule:
Work setting:
Experience:
- Auditing Hospital Medicine Hospitalist and ED: 3 years (Required)
- Coding Hospital Medicine Hospitalist and ED Pro and Tech: 5 years (Required)
- Coding FSED: 5 years (Required)
License/Certification:
- CPMA Certification (Required)
- CPC or CCS/CCS-P Certification (Required)
- CEMC, COC Certification is a plus (Preferred)
Work Location: Remote