hero

Life Works Here

Join our talent network, explore companies and search for jobs. Employment is abundant, commutes are short, and the region is filled with a sense of possibility, a place where you can have a real impact.
Leverage our network to build your career.
Tell us about your professional DNA to get discovered by any company in our network with opportunities relevant to your career goals.

Profee Coding Auditor

Washington Regional Medical Center

Washington Regional Medical Center

Fayetteville, AR, USA
Posted on Monday, June 17, 2024

Job Details

Washington Regional Med. Ctr. - Fayetteville, AR
Full Time
Certification in related field
Day
Admissions & Billing Services

Description

Position Summary

The role of the Profee Coding Auditor reports to the Profee Audit Manager. This position is responsible for chart reviews of medical records for clinic, outpatient, and inpatient provider claims. The position is responsible for management, implementation, and delivery of assigned audit phases, including planning, fieldwork, and reporting.

Essential Position Responsibilities

  • Conduct focused chart reviews, audits, risk adjustment and compliance reviews on providers and clinics, as directed by management, tracking results and identifying trends and deficiencies for follow up training for providers and coders, as necessary.
  • Report concise and detailed recommendations to improve documentation of E/M services, CPT, specificity of ICD10 codes and RAF scores.
  • Provide timely identification of deficiencies and educational needs to providers and coders.
  • Support coders by performing quality assurance reviews and providing appropriate education.
  • Create educational material and present training to providers and coders, as needed.
  • Independently, or as directed, research complex coding, E/M services, Procedural Coding, documentation requirements and HCC issues and remain knowledgeable of coding and compliance changes as communicated by CMS, HHS, AHA, AMA, Federal Register, and third-party contracts.
  • Participate in PTT and other provider meetings, as needed.
  • Protect data integrity and validity.

Qualifications

  • Education: High school diploma or GED, required. Associates degree in related field or equivalent experience
  • Licensure and Certifications: CPC, CRC or other comparable coding credentials required.
  • Experience: 3-5 years of auditing experience. Thorough understanding of Risk Adjustment, HCCS coding, ICD coding, HEDIS, and CPT coding. Excellent communication, presentation, and analytical skills.

Work Environment: This position will spend 90+% of the time sitting while performing work in a standard office environment.