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Compliance Coding Auditor
Consensus Health
| Position Summary Provide client audits for all providers. The medical record or progress note will be audited for documentation to ensure compliance. Interacts with the practices non-provider and provider employees. Provides analysis to the providers for education. Duties and Responsibilities The duties include, but are not limited to: • 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. • Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services. • Interacts with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation. • Interacts with providers and management to review and/or implement codes and to update charge documents. • Generates reports as needed through various systems. • Assist in provider education. • 25% travel through the state of NJ. • Performs miscellaneous job-related duties as assigned.
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Qualifications or Education, Training and Experience • High School diploma or GED • Certificate in Medical Coding (AAPC) (AIHMA) or equivalent; at least 2- 3 years of experience directly related to the duties and responsibilities specified. • Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis (doesn’t replace the necessary AAPC or AHIMA coding certification required). Knowledge and Skills/Expected Competencies • Proficient in Microsoft Office Suite software and Windows 10. • Knowledge of auditing concepts and principles. • Advanced knowledge of medical coding and billing systems and regulatory requirements. • Ability to use independent judgment and to manage and impart confidential information. • Ability to analyze and solve problems. • Strong communication and interpersonal skills. • Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation. • Knowledge of current and developing issues and trends in medical coding procedures requirements. • Ability to clearly communicate medical information to professional practitioners and/or the public. • Detailed knowledge of medical coding systems, procedures, and documentation requirements. • Ability to adapt and modify medical billing procedures, protocol, and data management systems to meet specific operating requirements. • Ability to provide guidance and training to professional and technical staff in area of expertise. |
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