Auditor/Educator Physician

Omega Healthcare Management Services Pvt. Ltd.; Boca Raton (FL); On-site; USD 70,000 - 100,000; Full time

Job summary

Omega Healthcare Management Services Pvt. Ltd. is seeking an experienced coder education specialist to review inpatient, outpatient, and professional fee records for coding accuracy and documentation quality.

The role emphasizes feedback, coaching, and developing education plans to improve performance. The ideal candidate will have at least 5 years in Coding/HIM, auditing experience, and relevant certifications, with strong presentation and stakeholder communication skills to educate providers

Qualifications

• Minimum 5 years’ experience in Coding and HIM operations with progressive responsibilities and at least 3 years’ experience in auditing and delivering feedback.
• Strong working knowledge of Coding terminology, guidelines, diagnostic and procedural codes, and exposure to delivering training through demonstrated past successes.
• Bachelor’s Degree in HIM or equivalent or a combination of advanced formal training and relevant experience.
• CCS, CCS-P, CPC, CPC-P, CPC-H, RHIA or RHIT certification
• Working knowledge of Microsoft products for creating training materials.

Responsibilities

• Review medical records for accuracy of coding and data quality.
• All diagnosis and procedure assigned ICD-10-CM and ICD-10 PCS codes
• Evaluation and Management, CPT, HCPCS
• Adherence to Guidelines
• Teaching Physician Attestations
• Use relevant references to perform CPT guidelines and CMS guidelines
• Communicate effectively with client management, coders, and providers
• Create an action plan that articulates strengths and areas requiring development
• Assist in creating additional learnings that address coding problems and documentation gaps
• Solicit feedback from program participants regarding training content
• Capitalize on electronic delivery avenues
• Make recommendations to training content and delivery based on evaluations
• Keep abreast of training and development research
• Perform duties in compliance with Company policies and HIPAA

Skills

HIM operations

Coding terminology

Auditing

Training delivery

Stakeholder communication

Education

Bachelor’s Degree in HIM or equivalent

CCS

RHIA or RHIT

CPC

Tools

Microsoft Office

Job description

For assigned coders and providers, review Inpatient, Outpatient or Professional Fee medical records for coding accuracy and medical record documentation as it impacts the correctness of the coding. Provide feedback and deliver additional education to correct inaccurate coding and improve documentation.

Essential Job Functions

• Review medical records for accuracy of coding and data quality.
• All diagnosis and procedure assigned ICD-10-CM and ICD-10 PCS codes
• Evaluation and Management, CPT, HCPCS
• Adherence to Guidelines
• Teaching Physician Attestations
• Use relevant references to perform the Current Procedural Terminology (CPT-4) Official Coding Guidelines, Coding Clinic, CPT Assistant, CMS guidelines, etc.
• Communicate effectively with client management, coders, and providers. Provide information regarding work progress, actions, and issues in a timely and effective manner.
• Create an action plan that articulates strengths and areas that may require ongoing development to ensure an effective and successful program.
• Assist in creating additional learnings that addresses coding problems and documentation gaps.
• Solicit feedback from program participants regarding training content or delivery enhancements that would further improve coder/provider effectiveness.
• Capitalize on electronic delivery avenues.
• Make recommendations to training content, length, delivery, or other aspects of training based on evaluations and feedback from HIM organization/Provider practice.
• Keep abreast of training and development research such as learning theory, motivation theory, and new materials, methods, and techniques.
• Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.

Key Success Indicators/Attributes

• Ability to prioritize and multi-task in a fast-paced, changing environment.
• Ability to speak and educate providers face to face.
• Demonstrate ability to work in all work types and specialties.
• Demonstrate ability to self-motivate, set goals, and meet deadlines.
• Demonstrate leadership, mentoring, and interpersonal skills.
• Demonstrate excellent presentation, verbal, and written communication skills.
• Ability to develop and maintain relationships with key business partners by building personal credibility and trust.
• Maintain courteous and professional working relationships with employees at all levels of the organization.
• Demonstrate excellent analytical, critical thinking and problem-solving skills.
• Skill in operating a personal computer and utilizing a variety of software applications.
• Strong presentation skills with an ability to effectively communicate concepts, terminology, and practices.
• Capable of delivering training using multiple media, conducting role plays, assessing progress, and measuring training effectiveness.
• Demonstrated leadership and problem-solving skills, plus the ability to act/decide accordingly and take initiative.
• Ability to collect, create and research complex or diverse information.
• Exceptional customer service skills and the ability to plan, organize and exercise sound judgment.
• Ability to be positive and flexible in a fast-paced work environment, support management decisions, take responsibility for own actions, lead others to achieve goals, and follow through on commitments.
• Strong presentation and written communication skills with an ability to effectively communicate concepts, terminology, and practices.
• Capable of developing and delivering training using multiple media, conducting role plays, assessing progress, and measuring training effectiveness.
• Strong systems aptitude with a customer orientation and flexibility in work practices.
• Ability to work effectively, independently and as part of a team

Supervisory Responsibility

None

Position Type/Expected Hours of Work

This is a full-time position. Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m.

Travel

No travel

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.

Required Education and Experience

• Minimum 5 years’ experience in Coding and HIM operations with progressive responsibilities and at least 3 years’ experience in auditing and delivering feedback. Prior experience delivering training related to this field.
• Strong working knowledge of Coding terminology, guidelines, diagnostic and procedural codes, and exposure to delivering training through demonstrated past successes.
• Bachelor’s Degree in HIM or equivalent or a combination of advanced formal training and relevant experience.
• CCS, CCS-P, CPC, CPC-P, CPC-H, RHIA or RHIT certification
• Working knowledge of Microsoft products (such as PowerPoint, Word, Excel, Visio, and Publisher) for creating training materials.

Preferred Education and Experience

• Experience with e-learning coding software (such as Relias), a plus

Additional Eligibility Qualifications

N/A

Security Access Requirements

In addition to the specific security access required by the employee’s client engagement, the employee will have access to the Omega systems set forth in the “Standard Field Employee” profile.

• Microsoft Office
• ADP
• Oracle
• Reviewmate
• E1- All Field Employees
• Standard Employee
• Standard
• Access is based on client needs. Determined by manager and granted by Audit Implementation Manager

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcarealso prohibits harassment of applicants or employees based on any of these protected categories.

Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at [e-mail].

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employee may perform other duties as assigned.

About Us

Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com

We offer a comprehensive benefits package that may include health, dental, and vision coverage, voluntary insurance options, a 401(k) plan with employer match, professional development opportunities, paid time off, and holiday pay. Eligible employees may also have the opportunity to participate in bonus programs, commissions, or other variable incentive plans. Benefits and incentive eligibility may vary based on position, location, and tenure.

AAP/EEO Statement

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcarealso prohibits harassment of applicants or employees based on any of these protected categories.

Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at [e-mail].