Physician Quality Reporting System Auditor

Company	Scp HealthSee more
Address	Lafayette, LA
Form of work	Full-Time
Category	Information Technology

Job description

At SCP Health, what you do matters
As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.

Why you will love working here:

Flexible schedules and work-from-home opportunities
Strong track record of providing excellent work/life balance
Comprehensive benefits package and competitive compensation
Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.

What you’ll be doing:

The PQRS Auditor role is responsible for documenting areas of risk within the revenue cycle. Core operation is to discover opportunities pre and post billing that will allow for appeals, system updates and process changes to prevent future losses/misses.

Provide ongoing guidance, training and education as it relates to PQRS, and any other reviews performed to deliver quality services.
Perform auditing, coding, editing, and review processes (deficiency, nonbillable, denial, and other) as directed by Pro Code, Inc.
Perform timely filing reviews as necessary to ensure deadlines are met.
Utilize available systems and reports to identify issues in order to assess and determine further coding, editing or auditing needs.
Provide other services as needed for complementary service lines. (ie. Hospital Medicine, Urgent Care, etc.)
Comply with HIPAA requirements in relation to all chart activities.
Maintain required procedures in line with coding policies and procedures.
Coordinates, facilitates, and acts as a liaison for internal and external coding reviews as specified in the Corporate Compliance Plan.
Provides and reviews data submitted for weekly Key Performance Indicators.
Attend appropriate professional and educational meetings.
Perform other duties as deemed necessary or required.
Assist with additional projects as requested by Coding Management.
Provide guidance and assistance to the global PQRS team as it relates to PQRS quality reviews.

Who/What we are looking for:

College Graduate, Bachelor of Science or above, HIM candidates must possess current RHIA.
Current Coding Certification(s) from AAPC, AHIMA, or both. Degreed candidates other than HIM/RHIA evaluated for proficiency/experience in coding.
Minimum one-year full-time coding experience and/or successfully completed Pro Code training and demonstrates proficiency in accuracy and production according to established guidelines and in line with obtaining appropriate certifications.

SCP Health and its affiliated companies (collectively, “SCP Health”) require applicants for specific positions, such as those onsite at a client company/healthcare facility or affiliate to be vaccinated against COVID-19 as a condition of employment, except where prohibited by state or local law. To demonstrate compliance with SCP Health’s vaccination policy, proof of COVID-19 vaccination status will be requested upon a conditional offer of employment for onsite positions at a client company/healthcare facility. SCP health will consider religious and/or medical/disability accommodation and other legally required exemption request as required by applicable law.

To learn more about SCP Health, please visit:
www.scp-health.com

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