Physician Compliance/Coding Auditor

Physician Coding Auditor
The Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for Surgical, procedural and E/M based coding.
Orlando Health is committed to providing benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions. "Orlando Health Is Your Best Place to Work" is not just something we say, it's our promise to you.
Orlando Health proudly embraces and honors the individuality of our team members. By sharing different ideas and perspectives and working together as a team, we are better able to relate to, care for and authentically serve our patients and families who make up the collective populations in our community. So, no matter who you are, what you believe or how you express yourself, you are welcome here.
Orlando Health - Benefits & Perks:

Competitive pay
Evening, nights, and weekend shift differentials offered for qualifying positions
All inclusive benefits (start day one)
Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility benefits, back up elder and childcare, pet insurance, PTO/holidays, and more for full time and part time employees
Responsibilities:

Responsible for internal auditing and analyzing professional coding for all service lines
Review medical records to ensure coding accuracy
Identify and communicate physician documentation and coding opportunities for improvement
Provides feedback to physicians, non-physician providers, physician office staff, administration, practice managers, and team members of the Physician and Professional Services Central Business Office regarding best practices to ensure physician coding compliance
Collaborates with Physician Coding Education Team to ensure appropriate and complete coding accuracy for payor guideline reimbursement
Utilizes resource material available in department, CMS, AMA, AHCA and federal registry to support coding practices
Maintains patient and coder confidentiality audit results
Collaborate with physician coding leadership for monitoring coding quality
Participate in Health Plan Audits
Follow and adhere to Standards of Ethical Coding, all applicable regulations and guidelines, and all client specific policies
Perform physician queries for coding and documentation clarification during concurrent chart review process
Serves as a resource to new coders
Addresses all Orlando Health departments professionally and positively, in all settings, by always maintaining a high level of professional demeanor and dress
Proficiency in coding including ICD-10, CPT, E/M, modifiers while maintaining a 90% accuracy
Adhere to Standards of Ethical Coding, all applicable regulations and guidelines, and all client specific policies
Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state, and local standards
Maintains compliance with all Orlando Health policies and procedures
Attends payor, departmental and interdepartmental meetings as required
Works in collaboration for testing, training, and mentoring incoming coders according to the coding guidelines and individual skills for the Division for which the coder will be assigned
Conducts focused physician reviews as needed and provides data to manager
Qualifications:

High School diploma or equivalent
Possesses exceptional knowledge in Microsoft Office Suite
Thorough knowledge of official coding guidelines as per AMA, AHCA, and CMS as evidenced by results of coding skills test of 90% or better
Must maintain one (1) of the following nationally recognized certifications:
CPMA certification required through the American Academy of Professional Coders
Coding Credential Required: AHIMA or AAPC credential
CEMA certification via National Alliance of Medical Auditing Specialists

~ Five (5+) years of professional based coding experience in multiple specialties is required