Medical Coding Auditor
Q1 Technologies - Franklin, TN

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PLEASE NOTE - THIS POSITION IS LOCATED IN FRANKLIN, TN - THIS IS NOT A TELECOMUTER POSITION - LOCAL CANDIDATES ONLY PLEASE. Job Summary
    Responsible for providing coding education to providers, receivable staff and operational leaders that may be critical of practices within the health centers and operations. Collaborates with providers, managers and other staff in order to promote greater understanding of correct coding initiatives and acquire their cooperation in reaching the required standards. Accountable for coding audit reports based on the results of scheduled and ad hoc audits performed. Prepares reports as required by standard operating procedures. Work with other coding auditors to follow up on audit findings and improve coding standards. Recommends process changes / improvements within Department and Operational policies and procedures or system changes to reduce losses or improve efficiency.

    Job Responsibilities (listed in order of importance and/or time spent)
    Produces coding audit reports based on the results of scheduled and ad hoc audits performed. Prepares reports as required by standard operating procedures.
    Effectively leads and facilitates all audit related meetings and communications with CBO team members, health center staff and leaders, providers, Business Partners, and Executive Leadership as required.
    Provides coding education to providers, receivable staff and operational leaders that may be critical of practices within the health centers and operations. Collaborates with providers, managers and other staff in order to promote greater understanding of correct coding initiatives and acquire their cooperation in reaching the required standards.
    Processes questions and resolves identified issues from the health center providers, staff, and other departments. Makes recommendations to correct the root-cause of errors identified.
    Assist in the development and implementation of policies to support the coding audit function.
    Identify training needs through the audit program and provide the necessary training identified.
    Ability to establish and maintain constructive working relationships with all parties related to the work assigned, effectively communicating relevant audit results to superiors. Resolves any escalated issues or non-compliant request with correspondent payor or escalates to management. Responsible for informing all parties related to the audits performed of progress and/or status addressing underlying needs that affect accurate coding and reporting.
    Work with other coding auditors to follow up on audit findings and improve coding standards. Recommends process changes / improvements within Department and Operational policies and procedures or system changes to reduce losses or improve efficiency. Identify and researches opportunities, issues, and requests and communicates with the team. Accountable for identifying potential risks and execute plan(s) to avoid risks before they occur.
    Reviews audit documentation to ensure it is in compliance with payer requests and procedures. Reviews third party audit reports submitted by service provider and performs internal audits for accuracy.
    Responsible for understanding department processes, answering questions from the shared Service Provider and health center staff, obtaining missing information and resolving issues from Operations, auditing accuracy of both shared service provider work and health centers, and preparing all reports and reconciliations needed for audits and management reporting.
    Works independently or with a team when assigned to group projects to meet goals and objectives.

    Basic Qualifications & Interests (BQIs)
    High school diploma and at least 4 year experience delivering coding education, performing medical chart coding, performing medical chart audits, and experience with Evaluation and Management coding.
    Required CPC certification in medical coding as granted by AAPC.
    At least 3 years experience in healthcare billing and receivables.
    At least 1 years experience training others in medical coding and operational processes.
    Experience in auditing the work of others (i.e. Checking documents for correct entry based on requirements, mathematical accuracy, and proper coding.)
    Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.
    Intermediate level skill in Microsoft Excel (for example: using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling).

    Travel Requirements: (if required)
    Willing to travel up to 10% of the time for business purposes (within state and out of state).

    Preferred Qualifications & Interests (PQIs)
    Bachelors degree and at least 1 year experience delivering coding education and performing medical chart coding audits.

    Q1 Technologies - 19 months ago - save job - block
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