DE - Coding and Billing Auditor - Dover

Job Type : Permanent Full Time

Job Description : Job is fully onsite.

General Summary :

Performs data quality reviews on provider records to validate the ICD- 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. 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.
• Audits all establish provider medical records on by annual basis :

a. Audits medical records for accurate CPT coding assignment.

b. Maintains audit lodge for BHMG

c. Compiles reports with an analysis of findings from the medical record audits.

d. Ensures the selected CPT code supports the clinical documentation contained in patient record.

e. Consistently meets established productivity targets for record audits.

a. Communicates (verbal / written) with providers to validate observations and suggest additional and / or more specific documentation

b. Designs and implements, in collaboration with the Revenue Cycle Manager specific tools to support medical record physician documentation.

c. Develops and implements plans in coordination with the Revenue Cycle Manager for both formal and informal education of providers.

d. Communicates to participants the benefits of complete clinical documentation.

Required Education, Credential(s) and Experience :

Education : Associate Degree Related field

Credential : Certified Professional Coder

Experience : Five () years in Inpatient / Outpatient coding and auditing experience

Preferred Education, Credential(s) and Experience :

Education Bachelor Degree Related field

Credential : Certified Professional Coder

Experience : Coding in multi-specialty group practice setting

Minimum Years of Experience :

Sub Specialties : Medical Coding Auditor

Job Details

Job Start Date :

Number of Positions :

Maximum Submissions Per Job :

Shift Information :

Days, Full Time

State License Details :

Upon Acceptance

Bilingual :

Holiday Coverage Required :

Minimum Years of Experience :

Miscellaneous Will facility accept ? :

Incidentals provided by facility :

Mileage Reimbursement :

Mileage Details :

Bonuses :

No bonuses listed

Expenses : No expenses listed