Job Details
Description
Welcome and thank you for your interest in working for Riverchase Dermatology! At Riverchase, we take pride in our Culture of Service Excellence.
NOTE TO CANDIDATES: Challenge brings out the best in us. It also attracts the best. That’s why you’ll find some of the most talented people at our company. Riverchase Dermatology is a premier dermatology practice and employer and our exceptional team members make this possible! Additionally, our team members find their contributions rewarding and have the opportunity to make an impact on a larger scale.
Our Revenue Cycle Team is committed to successful revenue management and currently has an excellent career opportunity for a Coding Quality Auditor in Fort Myers, Florida with future potential to work remotely. In the role of Coding Quality Auditor, you will be part of a dynamic team dedicated to documentation and revenue integrity. This position requires the ability to perform in a manner that ensures a collaborative work environment is maintained, encourages teamwork and high reliability. Dermatology or plastic surgery experience is a plus!
JOB SUMMARY
The Coding Quality Auditor will ensure coding and billing compliance through ongoing audits and education of providers and staff. Using a combination of regulatory, coding, documentation, and billing knowledge the Coding Quality Auditor will complete reviews of assigned providers to assess the adequacy of the medical record documentation to support the services billed in accordance with professional fee coding and billing guidelines investigating and researching claims for aberrant billing patterns through review of the medical record documentation.
The Coding Quality Auditor will work with the HIM to monitor and aid in in improving the quality of documentation related to the requirements to bill for services provided as needed. It is the primary function of the Coding Quality Auditor to provide first line coding support to providers, on-going training and education to providers, clinical staff, and other affected personnel for improved documentation, best coding practices to ensure compliance with Riverchase Dermatology standards, Medicare, OIG, AMA, and health insurance payer policies.
Job Responsibilities:
EOE DFWP:
Description
Welcome and thank you for your interest in working for Riverchase Dermatology! At Riverchase, we take pride in our Culture of Service Excellence.
NOTE TO CANDIDATES: Challenge brings out the best in us. It also attracts the best. That’s why you’ll find some of the most talented people at our company. Riverchase Dermatology is a premier dermatology practice and employer and our exceptional team members make this possible! Additionally, our team members find their contributions rewarding and have the opportunity to make an impact on a larger scale.
Our Revenue Cycle Team is committed to successful revenue management and currently has an excellent career opportunity for a Coding Quality Auditor in Fort Myers, Florida with future potential to work remotely. In the role of Coding Quality Auditor, you will be part of a dynamic team dedicated to documentation and revenue integrity. This position requires the ability to perform in a manner that ensures a collaborative work environment is maintained, encourages teamwork and high reliability. Dermatology or plastic surgery experience is a plus!
JOB SUMMARY
The Coding Quality Auditor will ensure coding and billing compliance through ongoing audits and education of providers and staff. Using a combination of regulatory, coding, documentation, and billing knowledge the Coding Quality Auditor will complete reviews of assigned providers to assess the adequacy of the medical record documentation to support the services billed in accordance with professional fee coding and billing guidelines investigating and researching claims for aberrant billing patterns through review of the medical record documentation.
The Coding Quality Auditor will work with the HIM to monitor and aid in in improving the quality of documentation related to the requirements to bill for services provided as needed. It is the primary function of the Coding Quality Auditor to provide first line coding support to providers, on-going training and education to providers, clinical staff, and other affected personnel for improved documentation, best coding practices to ensure compliance with Riverchase Dermatology standards, Medicare, OIG, AMA, and health insurance payer policies.
Job Responsibilities:
- Conducts pre-pay and post-pay audits to ensure accurate claims payments and denials.
- Audits medical record documentation to identify coding deficiencies of services billed i.e. under/over coding.
- Reviews medical record documentation to identify all services provided are accurately and appropriately reported using correct CPT and ICD-10 codes.
- Communicates with providers regarding medical record documentation to maximize accuracy, completeness, and compliance with standards of practice and current coding guidelines.
- Researches and resolves complex coding/documentation issues.
- Serves as coding expert resource for the providers.
- Reports unusual and complex issues and situations to HIM for guidance. Recommend action plans and suggest process for improvements.
- Communicates audit finding with HIM. Supports HIM in effectively and efficiently addressing and resolving all coding and documentation issues.
- Provides support to billing establish and achieve revenue cycle goals and objectives
- Identifies trends/problems in medical documentation and recommends possible solutions
- Perform audit of documentation as requested by external entities and assist in record collection submission and appeals.
- Certified Professional Coder or Certifier Professional Dermatology Coder or equivalent. If hired with no certification; certification must be obtained within 6 months of hire or transfer to position.
- Responsible for maintaining current knowledge of coding guidelines and current CPT, ICD-10, and HCPCS coding, fee schedule reimbursement methodology, and regulatory requirements for provider coding and reimbursement
- Working knowledge of key coding concepts, such as CPT modifiers, surgical packages, medical record documentation requirements, and multiple procedure guidelines
- Computer skills and proficiency in internet search functionality is required
- Proficient in analyzing statistical data
- General understanding of professional fee billing processes and procedures
- Ability to operate basic office equipment and multi-line telephone system
- Knowledge of Microsoft Office and medical billing software
- Must be able to work independently with little supervision
- Travel required as necessary to all Riverchase Dermatology locations determined by the needs and growth of the practice.
EOE DFWP: