PPG Auditor/Educator

Phoebe Putney Health System; Albany (GA); On-site; USD 70,000 - 90,000; Full time

Job summary

Phoebe Putney Health System in Albany, GA seeks a CBO coding Auditor/Educator to audit medical record documentation and assign ICD-10-CM/PCS and HCPCS codes for billing, reporting and compliance with Official Coding Guidelines.

The role educates physicians and coders, queries for complete documentation, researches audit results, and serves as an educational advisor to staff and physicians. The position reports to the CBO Coding Manager and supports training materials and policy adherence.

Qualifications

• Minimum an associate degree in a related field or 8 years of related experience.
• 4 years of experience with ICD-10, CPT, and HCPCS coding.
• 4 years of knowledge of medical terminology.
• 3 years of experience in health information management or coding management in a physician practice/clinic setting (Preferred)

Responsibilities

• Audit medical record documentation and coding to determine ICD-10-CM/PCS and HCPCS codes.
• Educate physicians and clinical staff to ensure complete documentation and resolve incomplete information.
• Query physicians to resolve documentation issues.
• Educate and train coders on coding and reimbursement guidelines.
• Research audit results and denials and resolve via appeals and staff education.
• Serve as educational advisor to coding staff, clinical staff, and physicians.

Skills

ICD-10 coding

CPT coding

HCPCS coding

Medical terminology

Education

Associate degree in related field

Tools

Athena

Meditech

Job description

Job Summary

Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, internal and external reporting, and compliance with the Official Coding Guidelines for Coding and Reporting, payer regulations, and Clinic/hospital policy. Educates physicians and clinical personnel to ensure complete documentation in the medical record and queries physicians to resolve incomplete or conflicting information to ensure compliant coding and billing practices. Educates and trains coders to ensure both a working knowledge of coding and reimbursement guidelines and successful career ladder completion, including the development of training materials and reference documents. Researches audit results, error reports, and denials and resolves by successful appeal, staff education, and correction of discrepancies. Serves in an educational and advisory capacity to the coding staff, clinical staff, and physicians as it relates to documentation, coding, and regulatory compliance. The CBO coding Auditor/Educator reports to the CBO Coding Manager.

Qualifications

2 year / Associate's Degree in related field; In leu of Associates Degree, eight (8) years directly related experience (Required)

Work Experience

• 4 years Experience with ICD-10, CPT, and HCPCS coding (Required)
• 4 years Extensive knowledge of medical terminology (Required)
• 4 years of related Revenue Cycle healthcare experience, preferably within coding and billing (Preferred)
• 3 years of experience in health information management or coding management in a physician practice/clinic setting (Preferred)
• Prior Athena or Meditech experience. (Preferred)
• Experience with any of Phoebe Provider Group’s legacy financial systems (Preferred)

Licenses and Certifications

Required Certifications/Licensures:
CPMA, Certified Coding Specialist (CCS), Certified Coding Specialist – Physician (CCS-P), or Certified Professional Coder (CPC)

Additional Duties

• Adheres to the hospital and departmental attendance and punctuality guidelines.
• Performs all job responsibilities in alignment with the core values, mission and vision of the organization.
• Performs other duties as required and completes all job functions as per departmental policies and procedures.
• Maintains current Knowledge in present areas of responsibility to include any specialty certification requirements (i.e., self-education, attends ongoing educational programs).
• Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
• Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs. For non-clinical areas, has attended training and demonstrates usage of age- specific customer service skills.
• Wears protective clothing and equipment as appropriate.