PHYSICIAN SERVICES AUDITOR
- JOB REQUIREMENTS
- Education
- American Health Information Management credentials (RHIA, RHIT, CCS-P, CPC)
- Experience
- Credentialed coder with at least ten years coding experience. Must have professional claim coding experience. Extensive knowledge of reimbursement systems. Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to physician documentation, professional coding and billing. Ability to code all types of records, professional and facility. Current with coding changes and regulations from various accrediting agencies and third party payers. Ability to interact well with physicians, physician offices, coding personnel, and others to obtain appropriate information needed to assign accurate codes. Must have demonstrated ability to collaborate with other team members. Demonstrates ability to prioritize and work independently.
- Physical
- Normal hospital environment. Close eye work and hearing within normal range. Oral communication. Operates computer, printer, fax and copier. Long periods of sitting. Occasional walking, bending, and climbing. May lift and carry up to 5 pounds.
- Education
- JOB SUMMARY
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- Conducts coding audits for all professional claims to ensure accuracy of billed data. Develops and implements database to track and monitor findings. Provides feedback to the Coding Manager on individual coders and opportunities for education. Arranges education for coders and physician/leadership on audit results. Works with Coding Manager to improve outcomes and ensure coding compliance.
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