Compliance Specialist Auditor
New
D
Duke HealthHealthcare
All Duke University remote workers must reside in one of the following states: North Carolina, Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington.Full-TimeMiddle
Salary not disclosed
Apply NowOpens the employer's application page
Job Details
- Experience
- Four (4) years of coding review experience
- Required Skills
- Microsoft OfficeCompliance
Requirements
- High School Diploma required.
- Four years of coding review experience applying compliance, auditing, and coding principles.
- Required certifications: CPC, RHIT, RHIA, or CCS.
- Deep knowledge of ICD-10-CM, CPT/HCPCS coding guidelines, and prospective payment systems.
- Understanding of anatomy, physiology, pharmacology, and medical terminology.
- Proficiency with MS Office applications.
- Ability to analyze detailed information to determine compliance with regulations.
- Strong verbal and written communication skills.
- Ability to work independently with a strong sense of responsibility.
Responsibilities
- Perform monthly QA audits of professional billing coders.
- Conduct retrospective quality audits to ensure accurate coding of ICD-10-CM diagnoses and CPT-4 procedures.
- Perform medical record reviews to verify documentation supports assigned codes.
- Identify coding and billing risk areas and report results to operations for action planning.
- Analyze coded records for compliance with federal, state, and third-party insurer rules.
- Serve as a subject matter expert for coding questions and provide ongoing feedback to providers and staff.
View Full Description & ApplyYou'll be redirected to the employer's site
