Address
Form of workSummary:
Reporting to the Manager of Physician Coding the Medical Coding Auditor remote reviews medical records to assure accurate consistent and compliant documentation coding and billing. The auditor will perform internal audits requested by Senior Management as well as audits initiated by Corporate Compliance and various payers. The Medical Coding Auditor will be responsible for documenting the results of each audit and identifying and reporting trends that may have compliance or revenue impact. Collaborates with the overall physician revenue cycle department to meet the metrics mission vision and values of the Lifespan organization.
Responsibilities:
Under the direction of the Manager of Physician Coding conducts internal audits to assure coder accuracy thorough provider documentation and adherence to compliance standards.
Assists with external payer audits and performs audits initiated by Corporate Compliance.
Acts as the coding subject matter expert and performs research for coding questions/issues when needed. Keeps abreast of regulatory changes affecting coding rules and regulations and updates Manager on these changes.
Develops appropriate internal audit tools.
Works with Manager and Report Analyst to pull data needed to perform audits.
Summarizes audit findings and reports findings to the Manager of Physician Coding including details as needed.
Identifies trends and recommends educational topics.
Maintains comprehensive knowledge of regulatory guidelines medical records medical terminology and clinical data.
Ability to prioritize requests organize tasks and meet deadlines.
Deals with highly sensitive and confidential information and adheres to HIPAA policies.
Performs other duties as assigned.
Other information:
BASIC KNOWLEDGE:
CPC or CCS certification required. CPMA and Bachelor's degree preferred.
Knowledge of ICD-9-CM ICD-10 CPT-4 coding anatomy and physiology.
Strong knowledge of documentation requirements LCD�s and CCI edits.
Working knowledge of Microsoft Word and Excel.
Excellent oral and written communication.
Demonstrated ability to observe HIPAA regulations.
EXPERIENCE:
Minimum of 5 years related experience preferably within a large integrated healthcare delivery system.
Epic experience highly desired.
High level of organizational and interpersonal skills to interact with Senior Management on matters having multiple and varying impact on department financial objectives and to respond effectively to competing needs for resources.
Work is performed in a typical office environment requiring extended periods of sitting standing and walking.
Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Lifespan is a VEVRAA Federal Contractor.
Location: Corporate Headquarters USA:RI:Providence
Work Type: Full Time
Shift: Shift 1
Union: Non-Union
