Medical Coding Auditor

Tricity Pain Associates is a leading chronic pain management company serving Texas. We are seeking a full-time Certified Medical Coder to join our Revenue Cycle team.

The Certified Medical Coder will be responsible to ensure documentation supports all coding and that coding practices are compliant with all relevant laws and standard practices. This will be done through monthly audits of providers and offshore coders, answering escalated questions and training as appropriate. Provides departmental support as directed by the Revenue Cycle Manager, and is responsible for the accurate and timely preparation, and submission of claims to payers and intermediaries. Performs all charge entry and procedural code audits.

Duties:

· Monthly audits for providers and mid-levels and coders to ensure documentation supportsbilling and provides feedback to drive improved documentation practices.

· Provides resolution to coding questions.

· Assist with provider questions and present coding concepts to drive improved documentation practices

· Identifies coding trends and areas of risk

· Handles escalated coding questions because of claim denials

• Communicates adverse trends related to coding denials
• Research coding topics and LCDs to ensure compliance with payor requirements and payer specific guidelines
• Provide documentation training to providers and support staff as needed
• Reviews records for audit requests related to RAC audits, SRMC audits, prepayment reviews, etc. prior to appeals or other documentation being sent
• Manages unbilled patient encounters at the office, ASC, hospital, and Pathology.
• Provides scrub claim logic for clean electronic submission to clearinghouse
• Protect the security of medical records to ensure confidentiality is maintained.
• Creates and/or updates the patient’s demographics and insurance information for new and established patients.
• Other duties as assigned

Requirements:

• CPC Certified (Required)
• 3 years of experience in a clinic setting (Preferred)
• Preferred experience in Spine, Orthopedic or Pain Management
• Knowledge of CPT and ICD-10 codes
• Overall knowledge of business office procedures and policies (required)
• Thorough knowledge of third-party payers, HMO’s, PPO’s, Medicare and Medicaid.
• Ability to work independently with minimum supervision
• Correct coding for diagnosis and procedures
• Rely on experience and judgment to plan and accomplish goals.
• Strong troubleshooting and problem-solving skills
• Methodical and detail-oriented
• Organized
• Effective writer and oral communicator
• Ability to multi-task
• Production-minded
• Strong work ethic

Education: High school or equivalent required

Job Type: Full-time

Pay: $55,000.00 - $65,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Holidays
• Monday to Friday
• No weekends

Ability to Commute:

• San Antonio, TX 78258 (Required)

Ability to Relocate:

• San Antonio, TX 78258: Relocate before starting work (Required)

Work Location: In person

Salary : $55,000 - $65,000