Role Description
The Coding Auditor and Educator role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. This role also involves performing Health Information Management duties, ensuring the accuracy, maintenance, security, and confidentiality of patient's health information.
This position has frequent and daily interactions with Medicine Professional Group physician and non-physician providers. Responsibilities include:
• Supportive coding instruction related to primary diagnosis and procedural coding.
• Ensuring the accuracy of coding and documentation of appropriate E/M visit level and inclusion of ICD-10-CM diagnosis codes.
• Chart reviews and detailed physician chart abstraction.
• Related coding education and evaluation of denials.
• Ensuring regulatory compliance.
• Sharing feedback with providers to capture the full scope of work.
• Collaborating with billing specialists on denials.
• Interacting with ModMed to ensure a smooth workflow for providers.
Salary range: $70-83k, depending upon experience. Remote position but must reside in the Eastern time zone in order to be considered.
Responsibilities
• Supports codes from final surgical/procedural operative reports signed by the provider.
• Reviews complex medical records to ensure documentation is supported.
• Works with ModMed to ensure correct plans, modifiers, and diagnoses are attached.
• Audits provider medical records and charges for compliance with coding and documentation standards.
• Provides continuing review and education of physician and ACPs to ensure appropriate level of care is reported.
• Maintains a thorough understanding of anatomy, physiology, medical terminology, disease processes, and surgical techniques.
• Correlates information supporting clinical documentation from various sources after review by the Attending Physician.
• Regularly meets with physicians and ACPs to provide education on billable services and documentation.
• Interacts with management and revenue managers about coding-related issues.
• Solves coding-related problems and answers questions from providers and office staff.
• Collaborates with billing specialists for expedient resolution of accounts.
• Develops plans to improve charge capture and billing/coding processes.
• Stays current with CPT and ICD-10-CM coding guidelines and communicates changes to stakeholders.
• Reports any potential compliance issues to the Director of RCM.
Qualifications
• Extensive knowledge of E&M coding surgical procedures and applicable modifiers.
• Understands and applies appropriate Center Medicare Services guidelines to coding.
• Advanced ICD-10-CM & CPT-4 coding conventions.
• Knowledge of Anatomy & Physiology and Medical Terminology.
• Ability to become a ModMed expert to help providers utilize the system.
• Effective written and verbal communication skills.
• Comfortable presenting to large groups of providers on coding topics.
• Ability to work independently and manage time effectively.
• Solid knowledge of the Inspector General watch list for coding and compliance.
Requirements
• Associates degree.
• Completion of Certified Medical Coding Program or two years of professional coding certification.
• Two of the following Certifications are required: Certified Professional Coder (CPC) and auditor certification- CPMA.
• Four (4) years of coding experience, with at least two (2) years in surgical abstraction.
• Preferred dermatology experience.
Benefits
• Medical, Dental & Vision insurance – effective 1st of the month after date of start.
• Short-term and long-term disability, Voluntary life (employee, spouse, and child), Critical Illness, and Hospital Indemnity – Effective the 1st of the month following date of hire.
• Company provided Basic Life/AD&D insurance.
• Paid time off.
• Paid holidays.
• Retirement Savings account.
• Employee discount on cosmetic services and products.
Physical Requirements
• This is largely a sedentary role, involving sitting most of the time.
• May involve movements such as walking, standing, reaching, and operating office equipment.
• Frequently required to speak, hear, communicate, and exchange information.
• Able to see and read computer displays and fine print.
• Occasionally lift and/or move up to 25 pounds.
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