Medical Auditor (Billing and Coding)

OrthoVirginia Inc; Richmond (VA); Hybrid; USD 65,000 - 85,000; Full time

Job summary

OrthoVirginia, Virginia's largest provider of musculoskeletal care, seeks a Medical Auditor (Billing & Coding) to join our team. This hybrid role requires travel by car to regional offices and focuses on auditing coding and documentation to ensure compliance with federal regulations.

Under the supervision of the Billing & Coding Compliance Manager, you will educate providers, monitor the compliance program, perform audits, and prepare reports to support accurate coding and documentation across

Qualifications

• Exemplifies OrthoVirginia's values - excellence, compassion and unity.
• Bachelor's Degree or equivalent with

Responsibilities

• Assists with monitoring of OrthoVirginia's Compliance Program as related to billing, coding, and documentation, including the OIG Compliance Program guidance for physician practices and third-party billing companies.
• Performs audits of coding and billing data for accuracy and compliance with federal regulations
• Conducts physician, APP, physical/occupational therapy and scribe coding and documentation education classes as needed/requested
• Educate clinicians on documentation and coding requirements to ensure accurate coding level assignment and compliance, utilizing exceptional written and verbal communication skills through face-to-face interactions, email, written correspondence, and telephone communication.
• Prepares requested reports by collecting, analyzing, and summarizing relevant information obtained through education, and other educational activities.
• Meets with assigned providers on a regular basis to educate and review results of audits
• Responsible for keeping up to date with all E/M and Therapy Documentation Guidelines
• Monitors all compliance issues identified during routine audits and recommends areas that indicate a focused audit may be necessary
• Assists with projects as directed

Skills

Auditing

Communication skills

Education

Bachelor's Degree or equivalent

Job description

At OrthoVirginia, you're part of a team dedicated to delivering expert orthopedic and therapy care across the state. As Virginia's largest provider of musculoskeletal care, we offer full-time and part-time opportunities in a collaborative, team-oriented environment. With more than 159 physicians in over 35 locations—including Lynchburg, Northern Virginia, Richmond, Southwest Virginia, and Hampton Roads - OrthoVirginia is a leader in orthopedic surgery, non-surgical care, and physical, hand, and occupational therapy. Our nationally recognized specialists treat a full range of musculoskeletal injuries and conditions, helping patients of all ages move, heal, and thrive. Join us and become part of a trusted network committed to excellence in orthopedic care.

Medical Auditor (Billing & Coding) Previous coding experience required Hybrid - must be able to travel by car to regional offices.

Job Description Responsible for conducting coding and documentation audits for assigned providers and consulting and educating providers on documentation requirements and other compliance issues related to billing. Under the direct supervision of the Billing & Coding Compliance Manager, this full-time position will work with physicians and other clinicians to ensure they comply with documentation and coding standards, regulations and requirements.

Job Responsibilities and Accountabilities:

• Assists with monitoring of OrthoVirginia's Compliance Program as related to billing, coding, and documentation, including the OIG Compliance Program guidance for physician practices and third-party billing companies
• Performs audits of coding and billing data for accuracy and compliance with federal regulations
• Conducts physician, APP, physical/occupational therapy and scribe coding and documentation education classes as needed/requested
• Educate clinicians on documentation and coding requirements to ensure accurate coding level assignment and compliance, utilizing exceptional written and verbal communication skills through face-to-face interactions, email, written correspondence, and telephone communication.
• Prepares requested reports by collecting, analyzing, and summarizing relevant information obtained through education, and other educational activities.
• Meets with assigned providers on a regular basis to educate and review results of audits
• Responsible for keeping up to date with all E/M and Therapy Documentation Guidelines
• Monitors all compliance issues identified during routine audits and recommends areas that indicate a focused audit may be necessary
• Assists with projects as directed

Qualified Candidates must meet all of the following criteria:

• Exemplifies OrthoVirginia's values - excellence, compassion and unity
• Bachelor's Degree or equivalent with