Physician Compliance Auditor II

Job Title: Physician Compliance Auditor II

The Physician Compliance Auditor II audits and evaluates compliance activities to ensure documentation meets standards. Establishes audit scope, uses tools, compiles data, reports findings, and provides recommendations and training. Audits may include documentation and coding accuracy for outpatient, inpatient, and emergency services using ICD-10, CPT, HCPCS, and other guidelines. Coding across multiple services lines including E/M services, surgical procedures, and diagnostic procedures. Multiple specialities including: Cardiology, Orthopedics, Family Medicine, Internal Medicine.

100% Remote

The pay range for this position is $26.66 (entry-level qualifications) - $40.00 (highly experienced). The specific rate will depend upon the successful candidate's specific qualifications and prior experience.

Performs chart audits and formulates recommendations based upon the audit findings and communicates them to the appropriate personnel. Implements coding reviews and creates work plans based on them. Ensures compliance issues and risks are identified and addressed. Develops curriculum for educating providers and staff on medical record documentation guidelines. Educates on diagnostic and procedural coding conventions and methodologies. Acts as a coding compliance and documentation resource and consultant for all providers, company administrators, and clinical staff. Assists in developing policies and procedures on coding compliance for clinics and the compliance department. Prepares and submits compliance reports to the compliance committee. Cross-trains other Physician Compliance Auditors in their area(s) of expertise to provide more depth and flexibility to the department.

Advanced knowledge of CPT, ICD-10, and HCPCS. CHC, AHFI, or CFE certification preferred. Maintains working knowledge of Federal, State, private payer, and other applicable legal and regulatory requirements for the compliance department. Ability to research complex topics regarding compliance and coding efficiently and accurately. Able to explain compliance concerns and resolutions clearly and concisely. Comfortable discussing them with all organization members. Proficient in Word, Excel, and PowerPoint. Four years auditing experience.

We believe that all people should feel welcomed, valued and supported.

EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification

EXPERIENCE - 4 Years of Experience

Auditing experience for Pro-Fee (providers) services with a focus on CPT as well as ICD-10-CM

Coding experience across multiple service lines

E/M services

Surgical procedures

Diagnostic procedures

Multiple Specialities including: Cardiology, Orthopedics, Family Medicine, Internal Medicine

CERTIFICATION/LICENSE/REGISTRATION

Active coding certification: CPC (Verified through AAPC) or CCS-P (Verified through AHIMA) required

As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.