PPG Auditor/Educator

Phoebe Physician Group, Inc.; United States; On-site; USD 65,000 - 90,000; Full time

Job summary

Phoebe Putney Health System is seeking a CBO Coding Auditor/Educator to audit medical records, assign ICD-10-CM/PCS and HCPCS codes for billing and reporting, and ensure compliance with guidelines and payer regulations. You will educate physicians and staff to optimize documentation and coding accuracy.

You will also train coders, analyze denials, and implement corrective actions while advising on regulatory changes.

Qualifications

• 2 year / Associate's Degree in related field; In lieu of Associates Degree, eight years directly related experience (Required).
• 4 years experience with ICD-10, CPT, and HCPCS coding (Required).
• 4 years extensive knowledge of medical terminology (Required).
• 4 years related Revenue Cycle healthcare experience (Preferred).
• 3 years health information management or coding management in physician practice/clinic (Preferred).
• Prior Athena or Meditech experience (Preferred).
• Experience with Phoebe Provider Group’s legacy financial systems (Preferred).

Responsibilities

• Audits medical record documentation and coding to extract data and determine ICD-10-CM/PCS and HCPCS codes for billing and reporting.
• Educates physicians and clinical staff to ensure complete documentation and resolves incomplete information with queries.
• Educates and trains coders on coding and reimbursement guidelines and career ladder development.
• Researches audit results, errors, denials, and resolves by appeal, staff education, and corrections.
• Acts in an advisory capacity to coding staff, clinical staff, and physicians on documentation, coding, and regulatory compliance.
• Reports to the CBO Coding Manager.

Education

Associate's degree

8 years related experience in lieu of degree

Tools

Athena

Meditech

PHOEBE legacy systems

Job description

Job Summary

Job Description 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)
• 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

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.

Phoebe Putney Health System is southwest Georgia’s preferred career choice for professionals who want to improve the community’s health by joining a respected, cutting-edge team. We offer you the opportunity to collaborate with the best colleagues in a friendly, close-knit setting that feels like family. Your career at Phoebe will allow you to apply learned skills, explore new paths and advance into greater opportunities. There's more for you at Phoebe. Phoebe is simply the best, most advanced healthcare provider in the region. If you want to work in the medical field, we are the preferred choice, with the best technology, the most specialists and the area’s top talent. If you are searching for a non-clinical career that allows you to serve the community and grow, you’ll also find us ideal. We’re one of the area’s premier employers, offering a close-knit culture, outstanding benefits and many ways to develop your career.