Coding and Billing Auditor
Job is fully onsite. Must have CPC. Professional Physician coding experience is a must; auditing experience is preferred.
Note: This position is open only to U.S. Citizens and Green Card holders.
General Summary:
Performs data quality reviews on provider records to validate the ICD-10 codes, CPT codes and clinical documentation. Audits provider (physician and midlevel providers) records for accuracy of principal and secondary diagnosis and/or procedures and ensures compliance with all reporting and documentation requirements. Educates providers, coders and charge entry personnel on coding guidelines and documentation requirements. Provides coding support to BHMG coding and billing staff.
Responsibilities:
Audits medical records for accurate CPT coding assignment.
Maintains audit lodge for BHMG
Compiles reports with an analysis of findings from the medical record audits.
Ensures the selected CPT code supports the clinical documentation contained in patient record.
Consistently meets established productivity targets for record audits.
Communicates (verbal/written) with providers to validate observations and suggest additional and/or more specific documentation
Designs and implements, in collaboration with the Revenue Cycle Manager specific tools to support medical record physician documentation.
Develops and implements plans in coordination with the Revenue Cycle Manager for both formal and informal education of providers.
Communicates to participants the benefits of complete clinical documentation.
Required Education, Credential(s) and Experience:
Preferred Education, Credential(s) and Experience:
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