Professional Fee Lead Coding Auditor

Managed Resources, Inc.; United States; Remote; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a Lead Professional Coding Auditor to join their remote team. In this pivotal role, you'll conduct audits of medical records, ensuring accurate coding and compliance with healthcare regulations. Your expertise will guide quality assurance efforts and support the audit team in delivering exceptional results. With a focus on multi-specialty coding, you'll leverage your experience to enhance documentation quality and contribute to client success. This is a fantastic opportunity to make a significant impact in a supportive and innovative environment, where your skills will be valued and developed further.

Qualifications

• 3-5 years experience in medical coding and auditing required.
• Must possess CPC or CCS-P certification.

Responsibilities

• Conduct audits of medical records for accurate coding.
• Enter data into audit software and compose findings.

Skills

CPT Coding

E/M Coding

ICD-10-CM Coding

HCPCS Coding

Quality Assurance

Data Entry

Communication Skills

Research Skills

Education

CPC or CCS-P Certification

CPMA Certification (preferred)

Tools

Microsoft Excel

EMR Systems

Job description

Lead Professional Coding Auditor
Full 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 responsibilities of the Professional Lead Auditor comprise of auditing medical records to determine accurate professional fee codes and completing formal audit reports. Additional duties under the direct supervision of the Professional Audit Supervisor will include audit client project oversight and quality assurance of other auditors on the team. This is a full time, remote, hourly position.
Reports to: Supervisor of Professional Audit and Education and/or Manager of Professional Audit and Education.Essential Job Functions:Complete the following functions in accordance with Managed Resources policies:

• Perform multi-specialty provider and coder audits by reviewing medical record documentation compared to selected professional fee codes. Code review includes E/M, CPT, HCPCS, ICD-10-CM and modifiers. Review of medical records may include office visits, hospital visits, minor and majority surgeries and diagnostic testing.
• Accurately enter data into the audit software and/or Audit Excel reports. Compose audit findings and recommendations comments.
• Evaluate the overall quality of physician documentation for quality improvement measures.
• Perform accurate audits using applicable coding guidelines and client protocols.
• Report findings and questions from audit staff to the Supervisor.
• Research coding guidelines and provide updates to audit team and Supervisor.
• Perform quality assurance reviews on team members to ensure accurate coding as assigned by the Supervisor.
• Communicate directly with Supervisor of Professional Audit and Education for client updates, assignments, and client deliverables.
• Communicate with audit team to assist with training, questions, work volumes, project updates and due dates.
• Communicate with client as needed and/or requested by the Supervisor (i.e. coding clarification, missing documentation, client calls, subject matter expert, etc.)
• Assist with project tracking.
• Assist with Audit report and Executive Summary report writing.
• 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.
• Certified Professional Medical Auditor (CPMA) credential from AAPC preferred.
• A minimum of three - five years’ experience required abstracting CPT, E&M, HCPCS and ICD-10-CM codes from provider documentation.
• A minimum of three-five years’ experience performing professional fee formal audits that include accurate coding, roll up trends and recommendations and written reports.
• A minimum of one-two years’ experience as a Lead or performing similar duties.
• Experience communicating with providers and Clients preferred.
• Requires advanced coding knowledge in multi-specialty surgical and medical specialties as assigned including but not limited to, PT/OT, Orthopedics, Neurology, OBGYN (family planning, birth control, preventative medicine, gynecological issues, global ob, & ob surgeries), infusions, medical and radiation oncology.
• Experience in E/M clinic & hospital coding & auditing.
• Extensive knowledge of medical terminology.
• Experience in researching and applying coding rules and regulations.
• Must have experience with data entry of codes into a database and/or software tool.
• Proficiency in Microsoft Excel, Word, and EMR (Electronic Medical Record) systems.
• Excellent oral and written communication skills.
• Have a positive, respectful attitude.

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