vbrown0214
Networker
Looking for an experienced Medical Documentation Auditor. Located in Greenville SC. Please send your resume to: VBrown@oaktreemed.com. This is not a remote position. Thanks!
Overall Job Functions:
Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge to provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements.
Essential Functions:
1. Audits medical record documentation to identify incorrectly coded services; prepares reports of findings and meets with providers to provide education and training on accurate coding practices and compliance issues.
2. Provides second-level review of billing performances to ensure compliance with legal and procedural policies and to ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices.
3. Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services.
4. Interacts with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation.
5. Trains, instructs, and/or provides technical support to medical providers, other care providers and billing staff as appropriate, regarding coding compliance documentation, regulatory provisions, and third party payer requirements.
6. Interacts with providers and management to review and/or implement codes and to update charge documents.
7. Ensures strict confidentiality of patient and financial records.
8. Attends coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations.
9. Performs miscellaneous job-related duties as assigned.
Minimum Job Requirements
? Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis. Certificate in Medical Coding and/or Medical Auditing from AAPC or AHIMA; at least 3 years of experience that is directly related to the duties and responsibilities specified.
Knowledge, Skills and Abilities Required
? Knowledge of auditing concepts and principles.
? Ability to use independent judgment and to manage and impart confidential information.
? Advanced knowledge of medical coding and billing systems and regulatory requirements.
? Ability to analyze and solve problems.
? Strong communication and interpersonal skills.
? Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation.
? Knowledge of current and developing issues and trends in medical coding procedures requirements.
? Ability to clearly communicate medical information to professional practitioners and/or the general public.
? Detailed knowledge of medical coding systems, procedures, and documentation requirements.
? Ability to provide guidance and training to professional and technical staff in area of expertise.
Working Conditions and Physical Effort
? No or very limited exposure to physical risk.
? No or very limited physical effort required.
? Work is normally performed in a typical interior/office work environment.
Overall Job Functions:
Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge to provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements.
Essential Functions:
1. Audits medical record documentation to identify incorrectly coded services; prepares reports of findings and meets with providers to provide education and training on accurate coding practices and compliance issues.
2. Provides second-level review of billing performances to ensure compliance with legal and procedural policies and to ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices.
3. Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services.
4. Interacts with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation.
5. Trains, instructs, and/or provides technical support to medical providers, other care providers and billing staff as appropriate, regarding coding compliance documentation, regulatory provisions, and third party payer requirements.
6. Interacts with providers and management to review and/or implement codes and to update charge documents.
7. Ensures strict confidentiality of patient and financial records.
8. Attends coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations.
9. Performs miscellaneous job-related duties as assigned.
Minimum Job Requirements
? Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis. Certificate in Medical Coding and/or Medical Auditing from AAPC or AHIMA; at least 3 years of experience that is directly related to the duties and responsibilities specified.
Knowledge, Skills and Abilities Required
? Knowledge of auditing concepts and principles.
? Ability to use independent judgment and to manage and impart confidential information.
? Advanced knowledge of medical coding and billing systems and regulatory requirements.
? Ability to analyze and solve problems.
? Strong communication and interpersonal skills.
? Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation.
? Knowledge of current and developing issues and trends in medical coding procedures requirements.
? Ability to clearly communicate medical information to professional practitioners and/or the general public.
? Detailed knowledge of medical coding systems, procedures, and documentation requirements.
? Ability to provide guidance and training to professional and technical staff in area of expertise.
Working Conditions and Physical Effort
? No or very limited exposure to physical risk.
? No or very limited physical effort required.
? Work is normally performed in a typical interior/office work environment.