What are the responsibilities and job description for the Physician Compliance Auditor position at UP Health System - Marquette?
UP Health System – Marquette
Who We Are:
People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. UPHS – Marquette is a 222 bed hospital and houses the region’s only Level II Trauma Center and Neonatal Intensive Care Unit (NICU). We also provide outreach with programs like annual health and safety fairs, health screenings for the entire family and more to keep our community healthy!
Where We Are:
In Marquette our fascinating history, rural landscape, abundant recreational opportunities, and welcoming people make the Upper Peninsula someplace special. From a thriving culinary scene to charming shops to historic lighthouses and museums, there is something for everyone in this beautiful lakeside gem.
Why Choose Us:
Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
Competitive Paid Time Off / Extended Illness Bank package for full-time employees
Employee Assistance Program – mental, physical, and financial wellness assistance
Tuition Reimbursement/Assistance for qualified applicants
Opportunities for education and training through partnership with Duke LifePoint Healthcare
And much more…
Position Summary:
Monitors, consults, educates, audits and performs trend coding decision making.
Reports to: Director
FLSA: Exempt
ESSENTIAL FUNCTIONS:
Responsible for reviewing and maintaining pertinent regulations and policies, ensuring all data elements are accurate and comply with all payor requirements.
Provide Onboarding education to all new providers.
Provides education regarding documentation requirements to improve coding quality and ensure accurate and complete capture of maximum revenue.
Work closely with the RCS (Regional Coding Specialist) program (HSC)
System Administrator for Systems Intergy and Ingenious Med
Reviews and interprets various regulatory billing and coding updates, to remain compliant and accurate and to minimize noncompliance.
Ensure accuracy of the EHRs and any new systems as they are implemented
Work closely with Finance, Medical Records, and other revenue producing areas or departments to assure accuracy and compliance to acceptable billing/coding guidelines and regulations
Minimum Qualifications:
Minimum Education
High school diploma or equivalent
*Years of relevant experience may be substituted for required education.
Required Skills
Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
Required Skills
Must have thorough understanding of ICD-10 Official Coding Guidelines for Coding and Reporting; HCPCS/CPT coding systems and CPT Assistant and Coding Clinic for HCPCS guidelines.
Required Skills
Certifications: (one of the following)
Certified Professional Coder (CPC)
Certified Evaluation and Management Coder (CEMC)
Certified Professional Medical Auditor (CPMA)
Minimum Work Experience
5 years related experience
Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran
