Lead Coding Auditor - Professional Fee

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Purpose:

The primary responsibilities of the Professional Lead Auditor comprise of auditing medical records to determine accurate professional fee codes and completing formal audit reports. Additional duties under the direct supervision of the Professional Audit Supervisor will include audit client project oversight and quality assurance of other auditors on the team. This is a full time, remote, hourly position.

Reports to: 

Supervisor of Professional Audit and Education and/or Manager of Professional Audit and Education. Essential Job Functions:Complete the following functions in accordance with Managed Resources policies:

• Perform multi-specialty provider and coder audits by reviewing medical record documentation compared to selected professional fee codes. Code review includes E/M, CPT, HCPCS, ICD-10-CM and modifiers. Review of medical records may include office visits, hospital visits, minor and majority surgeries and diagnostic testing.
• Accurately enter data into the audit software and/or Audit Excel reports. Compose audit findings and recommendations comments.
• Evaluate the overall quality of physician documentation for quality improvement measures.
• Perform accurate audits using applicable coding guidelines and client protocols.
• Report findings and questions from audit staff to the Supervisor.
• Research coding guidelines and provide updates to audit team and Supervisor.
• Perform quality assurance reviews on team members to ensure accurate coding as assigned by the Supervisor.
• Communicate directly with Supervisor of Professional Audit and Education for client updates, assignments, and client deliverables.
• Communicate with audit team to assist with training, questions, work volumes, project updates and due dates.
• Communicate with client as needed and/or requested by the Supervisor (i.e. coding clarification, missing documentation, client calls, subject matter expert, etc.)
• Assist with project tracking.
• Assist with Audit report and Executive Summary report writing.
• Track and enter time accurately and timely into our timekeeping system.
• Comply with policies regarding the use and disclosure of protected health information which includes accessing and using protected health information only to the extent necessary to fulfill the above-mentioned responsibilities
• Ensure compliance with federal and state laws, regulations, and standards related to health information and coding principles.
• Other duties as assigned.

Education and Experience:

• Must have one of the following current credentials from AAPC or AHIMA; CPC, CCS-P.
• Certified Professional Medical Auditor (CPMA) credential from AAPC preferred.
• A minimum of three - five years’ experience required abstracting CPT, E&M, HCPCS and ICD-10-CM codes from provider documentation.
• A minimum of three-five years’ experience performing professional fee formal audits that include accurate coding, roll up trends and recommendations and written reports.
• A minimum of one-two years’ experience as a Lead or performing similar duties.
• Experience communicating with providers and Clients preferred.
• Requires advanced coding knowledge in multi-specialty surgical and medical specialties as assigned including but not limited to, PT/OT, ED, Surgery, Orthopedics, Neurology, OBGYN (family planning, birth control, preventative medicine, gynecological issues, global ob, & ob surgeries), infusions, medical and radiation oncology.
• Experience in E/M clinic & hospital coding & auditing.
• Extensive knowledge of medical terminology
• Experience in researching and applying coding rules and regulations.
• Must have experience with data entry of codes into a database and/or software tool.
• Proficiency in Microsoft Excel, Word, and EMR (Electronic Medical Record) systems.
• Excellent oral and written communication skills.
• Have a positive, respectful attitude.

CodingAID, a division of Managed Resources Inc., is an Equal Opportunity Employer (EOE) M/F/D/V/SO

Job Type: Full-time

Pay: From $30.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Retirement plan
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Application Question(s):

• Are you seeking a full-time or part-time role?
• Do you have 5+ years of recent day to day auditing and performing QA on other auditors, leading projects, overseeing staff and deadlines, & report writing? Please list all that apply?
• Do you have 3+ years of educating both coders and providers?
• Do you have recent E/M coding & auditing experience for both clinic and hospital?
• Do you have recent experience coding/auditing for a minimum of 5+ specialties including but not limited to PT/OT, Orthopedics, Neurology, OBGYN (family planning, birth control, preventative medicine, gynecological issues, global ob, & ob surgeries), infusions, medical and radiation oncology? Please list all that apply.

Education:

• High school or equivalent (Required)

Experience:

• Microsoft Excel: 5 years (Required)
• Medical coding: 5 years (Required)

License/Certification:

• Certified Professional Coder (Required)
• CCSP (Required)

Work Location: Remote