Professional Documentation Improvement Auditor

Ardent Health Services is a leading provider of healthcare in communities across the country. Through its subsidiaries, Ardent owns and operates nearly 200 sites of care and 30 hospitals across six states. Together, our 24,000 employees and 1,200 employed providers touch more than 10,000 lives each day. With six Ardent entities earning recognition on Modern Healthcare's Best Places to Work list in 2022, Ardent and its facilities continue to earn recognition for outstanding workplace cultures where team members feel a sense of belonging and have opportunities to grow their careers. Ardent has also been recognized by Comparably's Best Places to Work Awards, earning honors in the Best CEO, Best Company for Women, Best Leadership Teams and Best Work Life Balance categories among others.
POSITION SUMMARY
The Professional Documentation Improvement Auditor specializes in reviewing and analyzing medical records, claims and workflow processes to ensure accuracy, completeness, and compliance with regulatory requirements. The primary goal is to improve the quality of clinical documentation, which plays a crucial role in patient care, compliance, billing, coding, and reimbursement processes.
Responsibilities

• Using audit tools, authoritative references, CMS and CPT guidelines, bell curves, etc. to analyze for trends, audit providers and coders, and provide education/feedback individually or in a group setting.
• Adhering to policies, procedures and regulations to ensure compliance.
• The following are some, but not all inclusive, of the responsibilities of the auditing function:
• Audits provider services using auditing tools such as EncoderPro and MD Audit.
• Adheres to provider auditing schedules and audit production standards set by Physician Compliance and Audit Services Director or the Physician Audit Managers.
• Maintains provider scoring results.
• Provides standard documentation on education feedback to providers in a timely manner.
• Ability to perform a trend analysis of providers bell curves and pull reports accordingly.
• Ability to work independently and use critical thinking skills.
• Ability to provide education using tip sheets to providers, in person meetings and/or Teams.
• Ability to multi-task and work in a fast-paced environment.
• Flexibility to audit specific service lines as needed.
• Flexibility to network with other team members as needed
• Ability to communicate effectively and professionally via email, phone, or Teams messages.
• Successfully completes educational courses assigned by Physician Compliance and Audit Services Director or the Physician Audit Managers .
• Participates in regular call-in huddles.

Qualifications
Education and Experience:

• Minimum of 3 years auditing experience or 5 years of coding E&M levels of service (multi-specialty, including office visits, preventive services, surgical procedures and hospital inpatient and observation services.
• E&M /Procedure/Surgery Auditing/Critical Care/Specialty Specific/Skewed Productivity Curves
• Application and validation of ICD-10 diagnosis codes based on coding guidelines
• CPC (Certified Professional Coder) or equivalent certification
• Additional specialty specific certifications (e.g. CCC - Certified Cardiology Coder, COBGC - Certified OB/GYN Coder) strongly preferred
• Auditing certification (e.g. CPMA-Certified Professional Medical Auditor) strongly preferred
• Revenue Cycle experience

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.