Professional Fee Auditor (Surgical & E/M)

Managed Resources, Inc.; United States; Remote; USD 80,000 - 100,000; Full time

Job summary

Join a leading provider of medical coding support as a Professional Fee Auditor. In this role, you'll leverage your extensive coding knowledge to audit medical records, ensuring accuracy and compliance with industry standards. You'll collaborate with healthcare providers, offering insights and recommendations to enhance documentation quality. This position offers a unique opportunity to impact healthcare delivery positively while working with a dedicated team committed to excellence. If you're passionate about coding and improving healthcare outcomes, this is the perfect opportunity for you.

Qualifications

• 5-7 years of experience auditing CPT, E/M, HCPCS, and ICD-10-CM codes.
• Advanced knowledge in at least 3 surgical and medical specialties.

Responsibilities

• Audit medical records for coding discrepancies and improvements.
• Provide written feedback on audit results and recommendations.
• Ensure compliance with health information regulations.

Skills

CPT Coding

ICD-10-CM Coding

HCPCS Coding

E/M Coding

Audit Skills

Communication Skills

Time Management

Organizational Skills

Education

CPC or CCS-P Certification

CPMA Certification (preferred)

Tools

Audit Software

Microsoft Excel

Microsoft Word

EMR Systems

Job description

Professional Fee Auditor (Surgical & E/M)

Surgical Coding Auditor - Professional Fee
Full time, Part time, Remote
CodingAID, a division of Managed Resources Inc. is a nationwide leading provider of medical coding support, coding and compliance reviews, educational programs, recruitment, revenue cycle management, and many other managed healthcare solutions. We’re proud to have served healthcare organizations and medical groups for over 30 years with proven success in meeting their operational challenges. Learn more about our mission and vision here.

Purpose:
The primary responsibility of the Professional Auditor is to audit CPT, HCPCS, ICD-10-CM, Modifiers, Units and identify documentation and coding discrepancies and improvements based on medical record documentation.

Essential Job Functions:

• Audit all E/M, CPT, HCPCS, ICD-10-CM, modifiers, units from the medical record documentation.
• Enter audit data into audit software or other audit report.
• Evaluate the overall quality of physician documentation for quality improvement measures.
• Perform accurate coding using applicable guidelines and client protocols.
• Communicate with client and/or providers as needed (i.e. coding clarification, missing documentation, etc.).
• Provide written feedback of audit results in the form of chart level comments, summary findings and recommendations.
• Communicate with Project Manager as needed (i.e. schedule changes, daily assignments/work volume, coding questions, etc.).
• Track and enter time accurately and timely into our timekeeping system.
• Comply with policies regarding the use and disclosure of protected health information which includes accessing and using protected health information only to the extent necessary to fulfill the above-mentioned responsibilities.
• Ensure compliance with federal and state laws, regulations, and standards related to health information and coding principles.
• Other duties as assigned.

Education and Experience:

• Must have one of the following current credentials from AAPC or AHIMA; CPC, CCS-P.
• CPMA preferred.
• A minimum of five - seven years’ experience required auditing CPT, E&M, HCPCS and ICD-10-CM codes.
• Requires advanced technical knowledge in a minimum of 3 surgical and medical specialties as assigned including General Surgery, GI and Bariatrics, Ortho, Cardiothoracic/Cardiovascular, ENT, Neurosurgery, Urology, Gynecology, Gyn/onc, Dermatology (MOHS Surgery), Trauma & Transplant.
• E/M coding experience for both clinic and hospital in the mentioned specialties as well as others is preferred.
• Extensive knowledge of medical terminology.
• Experience in researching and applying coding rules and regulations.
• Experience working in an audit software tool.
• Proficiency in Microsoft Excel, Word, and various EMR (Electronic Medical Record) systems.
• Excellent oral and written communication skills.
• Excellent time management and organizational skills.
• Have a positive, respectful attitude.

CodingAID, a division of Managed Resources Inc., is an Equal Opportunity Employer (EOE) M/F/D/V/SO.