The MRA Field Auditor is responsible for reviewing and auditing medical charts for documented unclaimed diagnoses from our network providers and accurately translating the diagnoses from the medical charts into ICD 9 codes.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
QUALIFICATIONS AND REQUIREMENTS : To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Performs comprehensive review of assigned medical charts per day.
- Follows and adheres to medical chart coding guidelines.
- Complies with HIPAA regulations while adhering to PHI.
- Assists in special projects as directed by the department head.
- Manages assigned workload efficiently and accurately while meeting deadlines.
- Attends department telephone conference call(s).
- Performs other duties as assigned.
EDUCATION and/or EXPERIENCE: An undergraduate degree from an accredited institution of higher learning required; minimum of two years experience in a medical office environment required; managed care experience preferred; or an equivalent combination of education, training and experience.
NECESSARY KNOWLEDGE, SKILLS AND ABILITIES: Ability to: work from designated office for collaborative/interactive fulfillment of duties; concentrate in an open-office “cubicle” environment; appropriately and directly interact with other staff members and/or outside associates; perform telephone and/or computer work for extended periods of time; operate office equipment such as computer, telephone, and copy/scan/fax machine; attend and participate in meetings via phone, computer, or in person.
Excellent oral and written communication skills with all educational levels or membership, including good grammar, voice and diction. Able to read and interpret documents. Proficient in MS Office (intermediate proficiency with Word and Excel programs) with basic computer and keyboarding skills.
REQUIRED TRAVEL: Up to ninety percent (90%) required ground travel to providers as well as mandatory attendance for department or team conferences
LICENSING AND CERTIFICATION: Certified Professional Coder (CPC)/ Certified Professional Medical Auditor (CPMA) certification(s) required; MRA coding experience required. Strong clinical background required. Current valid Florida driver’s license required. Good driving record required.
PHYSICAL DEMANDS: The physical demands described here are representative of those that should be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit.
The employee frequently is required to manipulate or use objects, equipment, tools, and/or controls.
May require specific vision abilities to perform this job.
Ability to lift, carry or exert items or objects of reasonable weight.
WORK ENVIRONMENT : The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Attendance at employer worksite is an essential job requirement.
The noise level in the work environment is usually moderate.
For the most part ambient room temperatures, lighting and traditional office equipment as found in a typical office environment.
ADDITIONAL INFORMATION: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
The duties listed above are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position.
We are proud to be an EEO/AA employer M/F/D/V. We maintain a drug-free workplace and perform pre-employment substance abuse testing.