Medical Coding Auditor - 403013

• Demonstrates knowledge and skills necessary to provide services based on the physical, psychosocial, educational, safety, and other related criteria appropriate population in his/her assigned area
• Maintains required core competencies.
• Complies with set Policies and Procedures (i.e. name tag, dress code, parking, smoking, etc.)
• Create and maintain schedules for quarterly audits with each physician and allied health professional.

• Audits medical record documentation to identify under-coded and up-coded services; prepares reports of findings and meets with providers to provide education and training on accurate coding practices and compliance issues
• Provides second-level review of billing performances to ensure compliance with legal and procedural policies and to ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices.
• Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services,
• Interacts with physicians and other patients care providers regarding billing and documentation policies, procedures, and regulations; obtain clarification of conflicting, ambiguous, or non-specific documentation.
• Trains, instructs, and/or provides technical supports to medical providers, and Medical Coding Analysts as appropriate regarding coding compliance documentation, and regulatory provisions, and third party payer requirements.
• Interacts with providers and management to review and/or implement codes and to update charge documents.
• Ensures strict confidentiality of financial records.
• Attends coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations.

Education

Required:

    High School

Licenses & Certifications

Required:

    C-Cert Pro Coder