Physician Coding Auditor

New

MedKoder, LLCMedical coding

Listing locations: USA; Position Location: 100% RemoteFull-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 are required.
Required Skills: Microsoft ExcelPowerPoint

Have a high school diploma; an associate or bachelor's degree is preferred.
Hold an active, good-standing AHIMA or AAPC professional credential, such as CCS-P, CPC, or another applicable AAPC stand-alone credential.
Have at least 5 years of recent physician coding experience.
Have at least 3 years of recent physician auditing experience.
Have subject matter expertise in E&M and surgical coding.
Have expert knowledge of medical terminology, anatomy and physiology, disease processes, CPT coding and AMA guidelines, ICD-10-CM coding and guidelines, and Medicare and Medicaid billing policies for professional services.
Have experience creating and implementing audit plans.
Have experience educating providers one-on-one or in group settings.
Demonstrate independent work, time management, research, organization, project switching, and deadline management.
Be proficient with Microsoft Word, Excel, PowerPoint, Windows, and healthcare information and billing systems.
An AAPC CPMA credential is preferred but not required.
Google Workspace, remote-work experience, multiple common EMRs, and experience in the listed profee specialties are preferred or a plus.

Perform professional compliance audits of coding and documentation for surgeries, visits, and other services across provider types, specialties, and clients.
Apply ICD-10-CM Guidelines, CPT Coding Guidelines, AHA Coding Clinics, AMA, CMS, and applicable specialty and payer guidance.
Select CPT codes and modifiers, and evaluate ICD-10-CM diagnosis coding.
Evaluate physician documentation, medical necessity, and applicable LCD, NCD, and NCCI requirements.
Review documentation for split/shared and incident-to services, Teaching Physician Guidelines, FQHCs, RHCs, and HEDIS, as applicable.
Score audits using the appropriate methodology and identify risk areas with mitigation strategies and recommendations.
Prepare detailed audit reports with findings and supporting documentation.
Prepare and present audit follow-up education and customized client education remotely and on-site.
Communicate issues, trends, and audit timeline progress to the Physician Audit and Education Manager.
Stay current on coding guidelines, maintain credentials, and participate in department and education meetings.

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