External Auditor Physician

Omega Healthcare Management Services; Boca Raton (FL); On-site; USD 70,000 - 110,000; Full time

Benefits offered by this job

Health insurance

401(k) plan with employer match

Professional development opportunities

Paid time off

Holiday pay

Job summary

Omega Healthcare Management Services seeks a skilled External Auditor Physician to review inpatient and outpatient medical records for coding accuracy and data quality, supporting MS-DRG and APC assignments.

The role emphasizes identifying query opportunities, writing compliant queries, and ensuring POA, discharge disposition, and modifier accuracy while collaborating with clients and Omega teams.

Qualifications

• Minimum of two years HIM experience, preferably as an Auditor.
• At least one year of auditing experience.
• Minimum of AHIMA approved Coding Certificate Program completion.

Responsibilities

• Review inpatient, outpatient, and physician services medical records for coding accuracy and data quality.
• Identify physician query opportunities and write compliant queries.
• Maintain auditing productivity based on client and Omega agreed requirements.
• Utilize ICD-10-CM/PCS, CPT-4/HCPCS coding guidelines and CMS guidelines for reviews.
• Develop and maintain relationships with key business partners.

Skills

HIM experience

Auditing/QA

Query writing

Data analysis

Organization & detail orientation

Education

AHIMA approved Coding Certificate Program

CCS/CPC/CPC-P/RHIA/RHIT certifications

Tools

Microsoft Office

ADP

Oracle

Job description

Under general supervision of client, Omega’s External Auditor Physician will perform reviews of inpatient and outpatient or Professional Services medical records for coding accuracy and medical record documentation as it impacts the accuracy of ICD-10-CM, ICD-10-PCS codes driving MS-DRG assignment and ICD-10-CM and CPT-4/HCPCS codes driving the APC assignment.The External Auditor Physician must be able to identify Physician query opportunities, write compliant queries, assess the accuracy of POA, discharge disposition and modifier assignments. External Auditor Physician performs data collection for quality and statistical purposes and reports the findings to Omega’s clients.

Essential Job Functions

Reviewinpatient,outpatient,orphysicianservicesmedicalrecordsforaccuracyofcodinganddataquality. Elements to be included in reviews can include:

AlldiagnosisandprocedureassignedICD-10-CMandICD-10PCS codes

AlldiagnosisandprocedureassignedICD-10-CMandICD-10PCS codes

AllCPTassigned codes

APCassignment Professional Services

AllCPT codes

AllE&MLeveling codes

MaintainauditingproductivitybasedonClientandOmegaagreedupon requirements

Utilize all available official references to perform reviews: to include but not limited to International ClassificationofDiseases,9 th Edition,ClinicalModification(ICD-9-CM),theCurrentProceduralTerminology (CPT-4) Official Coding Guidelines, Coding Clinic, CPT Assistant, CMS guidelines, etc.

• Demonstratestrongorganizationalskillsandbedetail oriented.
• Demonstrateabilitytoself-motivate,setgoals,andmeet deadlines.

Abilitytodevelopandmaintainrelationshipswithkeybusinesspartnersbybuildingpersonalcredibilityand trust.

Maintainscourteousandprofessionalworkingrelationshipswithemployeesatalllevelsofthe organization.

• Demonstrateexcellentanalytical,criticalthinkingandproblem-solving skills.
• Abilitytoidentifydeficienciesandtakecorrective action.

Thephysicaldemandsdescribedherearerepresentativeofthosethatmustbemetbyanemployeeto 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,orfeelobjects,tools,orcontrols;reachwithhandsandarms;climbstairs;balance;stoop,kneel, crouchorcrawl;andtalkorhear.Theemployeemustoccasionallyliftormoveupto25pounds.Specificvision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.

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. This position occasionally requires long hours and weekend work.

Musthaveatleasttwoyearsof HIMexperience,preferablyasan Auditor.

Atleastoneyearofauditing experience.

Minimumofsuccessfulcompletionofan AHIMA approvedCodingCertificate Program.

Preferred Education and Experience

None.

Additional Eligibility Qualifications

CCS, CPC, CPC-P, CPC-H, RHIA or RHIT

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

E1- All Field Employees

Standard Employee

Standard

Coder and Client Access 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] .

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, visitwww.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 [e-mail] .