Physician Coding Auditor
New
M
MedKoder, LLCMedical Coding
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.
- Active, in-good-standing AHIMA or AAPC certification (e.g., CCS-P, CPC).
- Minimum 5 years of recent physician coding experience.
- Minimum 3 years of recent physician auditing experience.
- Expert knowledge of E&M and surgical coding.
- Proficiency in medical terminology, anatomy, physiology, and disease processes.
- Strong understanding of Medicare and Medicaid billing policies.
- Experience creating and implementing audit plans.
- Experience educating providers in one-on-one or group settings.
- Proficiency with Microsoft Word, Excel, PowerPoint, and Windows.
- Ability to work independently and manage multiple projects simultaneously.
- CPMA credential is preferred.
Responsibilities
- Perform professional compliance audits of coding and documentation for multiple providers, specialties, and clients.
- Apply ICD-10-CM, CPT, and CMS coding guidelines accurately to select codes and modifiers.
- Evaluate physician documentation for medical necessity and adherence to LCDs, NCDs, and NCCI edits.
- Assess documentation accuracy for specialized areas like teaching physicians, FQHCs, RHCs, and HEDIS.
- Prepare and present customized audit findings and educational materials to clients.
- Identify risk areas and develop mitigation strategies for clients.
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