Physician Coding Auditor
New
USAFull-TimeSenior
Salary not disclosed
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Job Details
- Experience
- Minimum 5 years of recent physician coding experience and 3 years of recent physician auditing experience
- Required Skills
- Microsoft ExcelPowerPoint
Requirements
- High School diploma required; Associate or BS degree preferred.
- Successful completion of at least one AHIMA or AAPC certified program (e.g., CCS-P, CPC) with active credential in good standing.
- Successful completion of the AAPC CPMA credential is required.
- Minimum 5 years of recent physician coding experience.
- Minimum 3 years of recent physician auditing experience.
- Subject matter expert on E&M and Surgical coding.
- Expert knowledge of medical terminology, anatomy and physiology, disease processes, and CPT/ICD-10-CM guidelines.
- Knowledge of Medicare and Medicaid billing policies for professional services.
- Experience creating and implementing audit plans.
- Experience educating providers in one-on-one or group settings.
- Proficiency with Microsoft Word, Excel, PowerPoint, Windows, and healthcare information/billing systems.
- Ability to work independently, manage multiple projects, and meet deadlines.
Responsibilities
- Perform professional compliance audits of coding and documentation including surgeries, visits, and other services for multiple provider types across multiple specialties.
- Apply accurate coding and documentation guidelines, including ICD-10-CM, CPT, AHA Coding Clinics, AMA, CMS, and specialty-specific guidance.
- Evaluate physician documentation for adherence to medical necessity, LCDs, NCDs, and NCCI edits.
- Identify risk areas and provide mitigation strategies and recommendations.
- Prepare and present audit follow-up education and customized materials to clients remotely or on-site.
- Communicate with the Physician Audit and Education Manager regarding issues, trends, and audit timelines.
- Stay current on all coding guidelines and maintain necessary professional credentials.
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