DE - Coding and Billing Auditor - Dover

Job is fully onsite. Must have CPC. Professional Physician coding experience is a must, auditing experience is preferred. seeking a certified professional coder with significant experience in coding professional claims in a medical office-based setting. Experience with coding different specialties is preferred. Looking for a candidate who has interacted regularly with physicians to provide feedback and education on a regular basis General Summary: Performs data quality reviews on provider records to validate the ICD-10 codes, CPT codes and clinical documentation. Audits provider (physician and midlevel providers) records for accuracy of principal and secondary diagnosis and/or procedures and ensures compliance with all reporting and documentation requirements. Educates providers, coders and charge entry personnel on coding guidelines and documentation requirements. Provides coding support to BHMG coding and billing staff. Responsibilities: 1. Audits medical records for accurate CPT coding assignment. Compiles reports with an analysis of findings from the medical record audits. Ensures the selected CPT code supports the clinical documentation contained in patient record. Consistently meets established productivity targets for record audits. 2. Audits all establish provider medical records on by annual basis: a. Audits medical records for accurate CPT coding assignment. b. Maintains audit lodge for BHMG c. Compiles reports with an analysis of findings from the medical record audits. d. Ensures the selected CPT code supports the clinical documentation contained in patient record. e. Consistently meets established productivity targets for record audits. 3. Medical Staff Relationship: a. Communicates (verbal/written) with providers to validate observations and suggest additional and/or more specific documentation b. Designs and implements, in collaboration with the Revenue Cycle Manager specific tools to support medical record physician documentation. c. Develops and implements plans in coordination with the Revenue Cycle Manager for both formal and informal education of providers. d. Communicates to participants the benefits of complete clinical documentation. 4. Trains new employees on the BHMG revenue cycle team on coding and documentation guidelines 5. Assistant Revenue Cycle manager with evaluation of coding activities and the performance evaluation of the revenue cycle personnel as needed 6. Performs coding procedures as needed and warranted 7. Develops and implements plans in coordination with the Revenue Cycle Manager for both formal and informal education of providers. 8. All other duties as assigned within the scope and range of job responsibilities Required Education, Credential(s) and Experience: Education: Associate Degree Related field Credential: Certified Professional Coder Experience: Five (5) years in Inpatient /Outpatient coding and auditing experience Preferred Education, Credential(s) and Experience: Education Bachelor Degree Related field Credential: Certified Professional Coder Experience: Coding in multi-specialty group practice setting

Shift: Days, Full Time

Specialty Type: Medical Coding

Sub Specialties: Medical Coding Auditor
General Certifications: N/A
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