Lead Medical Coding Auditor & Compliance

Overview Looking to join and lead a dynamic team at Ohio State University Physicians where excellence meets compassion? Who we are With over 100 cutting-edge outpatient center locations, dedicated to providing exceptional patient care while fostering a collaborative work environment, our buckeye team includes more than 1,800 nurses, medical assistants, physicians, advanced practice providers, administrative support staff, IT specialists, financial specialists and leaders that all play an important part. As an employee of Ohio State University Physicians (OSUP), you'll be an integral part of a team committed to advancing healthcare, education, and professional growth. Our culture At OSUP, we foster a culture grounded in the values of inclusion, empathy, sincerity, and determination. We meet our teams where they are, coming together to serve each other and our community. Our benefits We know that having options and robust benefit plans are important to you. OSUP prioritizes the wellbeing of our team and that’s why we offer our employees a flexible, competitive benefit package. In addition to medical, dental, vision, health reimbursement accounts, flexible spending accounts, and retirement, we also offer an employee assistance program, paid time off, holidays, and a wellness program designed to support our employees so they can live their best lives. As an OSUP employee, you will be eligible for these various benefits depending on your employment status. Responsibilities Duties and Responsibilities: Conducts regular audits of clinical documentation and coding to identify areas for improvement and ensure compliance with federal, state, and payer regulations, and prepares comprehensive reports of audit findings with recommendations for improvement. Makes recommendations based on interpretations of identified coding patterns to propose procedure changes or proposed solutions to enhance compliance, mitigate risk and positively improve billing. Implements compliant and accurate coding solutions, independently executing coding changes when appropriate. Identifies patterns of incorrect coding, initiating look-back reviews to determine duration and impact and providing interpretations to the department. Identifies training needs and develops educational materials, collaborating with Senior Certified Coders to support ongoing professional development for Coders. Partners with providers to analyze and resolve complex coding inquiries. Provides suggestions and consultation to providers regarding billing codes to ensure accurate and compliant billing. Helps Coders stay informed on changes in coding regulations, guidelines, and payer policies. Liaises with external auditors as needed. Works independently to assess coding accuracy and provide strategic feedback to Coding Managers. Coordinates with leadership to address wRVU discrepancies and documentation gaps. Protects OSUP from compliance risk by ensuring accurate code application and audit defensibility. Uncovers opportunities to increase revenue and reimbursement through audit findings. Keeps procedures and training materials up to date. Participates in Epic roadmap discussions and contributes to workflow policy development. Collaborate with physician educators and compliance partners to resolve documentation issues and support coder education. Additional Duties: Required to complete all assigned training and competency requirements at hire and on an ongoing basis to maintain compliance with job-specific, regulatory, and organizational standards, including mandated topics such as privacy and workplace conduct. Partners with a manager or preceptor to address development needs and close skill gaps. Will maintain compliance with required dress code in order to provide high quality of care and service. Travel may be required to accommodate staffing levels at other clinical facilities. Attendance, promptness, professionalism, attention to detail, professional collaboration with all members of the care team, and politeness to customers, vendors, and patients. Engages in regular communication with supervisor(s) to review performance, receive constructive feedback, and align on goals and priorities. Actively seeks guidance and support when needed to ensure role expectations are met. Other duties or special projects as assigned. Qualifications Requirements: Bachelor’s degree or equivalent combination of related experience and education Certification of CPC, CCA, CCS, CCS-P, or similar designation At least 3 years of experience related to coding for physician services. Preferences : Experience working with Electronic Medical Records and IHIS Pay Range USD $60,026.47 - USD $90,039.71 /Yr. #J-18808-Ljbffr Ohio State University Physicians, Inc.