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Job Summary
The Professional Billing Quality Coding Auditor will support the Medical Group Coding and Education department by performing routine reviews of coders to ensure accurate coding. This position will also perform specialty reviews as identified by Coding and Education leadership. Prepares a summary of findings and presents reports to leadership on a monthly basis. Will assist with training coders on identified opportunities for improvement. Will also assist in preventing coding denials when applicable.
Accountabilities
* Performs multi-specialty reviews for the Medical Group validating the CPT, ICD-10, modifiers and HCPCS codes using official coding guidelines and CMS guidelines and prepares a summary of findings. - 30%
* Performs review of all coders within the department and prepares a summary of findings. - 30%
* Provides training to coders on identified issues found during reviews. - 10%
* Codes charges for professional billing based on review of clinical documentation. - 5%
* Identifies and assists management with the resolution of coding issues and process improvement. - 5%
* Assists in creating edits to prevent denials. - 5%
* Assists in creating a standardized process for front end coding including the development of training materials. - 5%
* Mentors and trains coders on correct coding guidelines. - 5%
* Interacts with other departments as needed to assist in resolving coding. - 5%
Supervisory/Management Responsibilities
This is a non-management job that will report to a supervisor, manager, director or executive.
Minimum Requirements
* Bachelor's Degree - Business or other related field
* 3 years - Multi-specialty Coding experience in professional billing
Required Certifications, Registrations, Licenses
* CPC Certified Professional Coder (AAPC) and
* CPMA Certified Professional Medical Auditor (AAPC)
Knowledge, Skills or Abilities
* Strong knowledge of medical terminology and basic anatomy and physiology with the ability to apply coding concepts to ensure correct coding. Strong analytical skills.
* Epic, Encoder Pro, 3M
* Ability to work independently and manage multiple projects consistently
* Basic computer skills
* Proficient computer skills (word processing, spreadsheets, database)
* Data entry
Work Shift
Day (United States of America)
Location
Independence Pointe
Facility
7001 Corporate
Department
70019178 Medical Group Coding & Education Services
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