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Perform comprehensive audits of physician and clinical fees to ensure coding integrity, medical necessity, and compliance with federal guidelines. Develop and lead educational curriculums and webinars for providers based on audit trends and regulatory changes.
The ideal candidate will have CIRCC Certification as well and experience in interventional coding.
E&M Coding Auditor/Educator performs comprehensive audits to determine integrity of coding/billing for physician & clinical fees, detection/correction of documentation, coding/billing errors and/or medical necessity of services billed. Audits consist of evaluation of the accuracy of documentation, including E/M and other payer codes, medical necessity, reimbursement overpayments and underpayments, and compliance with other documentation standards. Researches and applies all federal guidelines & compliance with the overall audit delivery. Develops and executes provider comprehensive educational opportunities/curriculums (coding resources, materials, tools, webinars, campaigns, etc.) based on audit results, noted trends & changes within coding compliance and regulatory guidelines, while supporting organizational compliance models. Leads provider‘s education events to discuss overall audit results overview, identifying trends and action plans. Provides support or project management for any other related audit and coding initiatives and assist in other related responsibilities as required by executive leadership team. Establishes positive working relationships as the subject matter expert with all parties to provide input on risk and ensure a sustained understanding of federal coding compliance requirements. Estimated pay range for this position is $26.13 - $33.97 / hour depending on experience.
EOE, including disability/vets
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