Coding Educator and Compliance Auditor – Remote Opportunity in Toledo, OH in University of Toledo Physicians

Job title: Coding Educator and Compliance Auditor - Remote Opportunity Company: University of Toledo Physicians Job description: University of Toledo Physicians' mission is to improve the human condition through excellence in patient care and medical discovery. Representing more than 200 physicians, UT Physicians are leaders in clinical care, research and education of the future physicians, providing care in a wide range of medical specialties from the most complex diagnoses and treatments to primary care for the entire family. The primary site of inpatient care services is at the University of Toledo Medical Center, but many of our physicians’ practice at hospitals and medical offices throughout the region. University of Toledo Physicians offers competitive pay and benefits including: 403B, Pension, health and tuition waiver at UT. POSITION SUMMARY Responsible for accessing HIPAA compliant medical record documentation from a number of systems, evaluating the medical record documentation by the providers or other personnel for coding accuracy by conducting random and focused coding audits; documenting, preparation and presentation of audit results; including investigations and presentation of educational/feedback in a friendly, courteous and professional manner. ESSENTIAL JOB FUNCTIONS AND ACCOUNTABILITIES

• Knows and adheres to all laws and regulations pertaining to patient health, safety and medical information.
• Contributes to the achievement of revenue cycle department goals and objectives, adhering to department policies, procedures and standards.
• Analyze provider documentation to assure appropriate evaluation and management levels are assigned using the appropriate Documentation Guidelines. Strong understanding of evaluation and management codes.
• Provides consistency in reporting medical information for internal fiscal procedures, regulatory compliance and billing.
• Reviews medical documentation within a patient’s medical record for accuracy in identifying all billing codes (ICD-10, CPT and/or HCPCS).
• Reviews claim denials and rejections pertaining to coding and medical necessity issues and when necessary, implements corrective action plan, such as educational programs, to prevent similar denials and rejections from recurring. Assists Finance Department with resolving insurance denials for outpatient claims related to coding issues.
• Performs medical record reviews to ensure compliance with established third-party reimbursement agencies and special screening criteria, including NCCI initiatives and correct usage of modifiers.
• Review physician charges from appropriate locale(s) for specified physicians.
• Understand diagnosis coding etiology and manifestation guidelines for appropriate ICD-10 coding.
• Assist with coding questions with follow up staff for proper payment of services rendered. Work with physicians on coding practices and updates as necessary.
• Keep current on billing trends and coding changes for assigned areas of specialty. Work in conjunction with Compliance Department regarding chart and diagnosis.
• Responsibilities include designing and documenting the EHR application and workflow test plans. Under direction, analyzes plans, organizes and coordinates the healthcare ambulatory applications and other related healthcare applications in the electronic medical record.
• Conducts regular audits and coordinates ongoing monitoring of codes accuracy and documentation adequacy. Identify coding deficiencies and recommend corrective action to improve third party payer reimbursement and minimize audit liability.
• Make independent decisions based on specialized knowledge.
• Demonstrated verbal and written communication skills, as well as interpersonal skills are essential. A strong customer service orientated approach to diagnosing and resolving workflow related issues. Requires telephone etiquette and e-mail correspondence with physicians.
• Maintains current coding credentials
• Applies standardized audit scoring methodology, established by the department, to report audit results and perform education in a timely manner.
• Make independent decisions based on specialized knowledge.
• Work effectively with others and as a team member.
• Provide excellent customer service at all times.
• Meets all job performance standards.
• Covers for and/or assists other staff members as needed. Performs other duties as assigned.
• Perform special projects and miscellaneous duties consistent with purpose of job as needed and requested.

REQUIRED QUALIFICATIONS

• Education: High School Diploma or equivalent
• License and/or Certification: Current certification from an accredited coding association (CPC, CPC-H, CCS, CCS-P, RHIT, CCA, etc.)
• Skills:
• Strong Communication skills
• Demonstrates interpersonal skills and ability to work with a diverse team

PREFERRED QUALIFICATIONS

• Education: Bachelor’s degree
• License and/or Certification: CPMA or CEMC
• Experience: 2+ years of coding, compliance, or auditing experience

WORKING CONDITIONS Primarily inside in well-lighted, well-ventilated areas. The above list of duties is intended to describe the general nature and level of work performed by people assigned to this classification. It is not intended to be construed as an exhaustive list of duties performed by the people so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct and control the work of employees under his/her supervision. Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex, pregnancy, sexual orientation, gender identity or gender expression, age, disability, military or veteran status, height, weight, familial or marital status, or genetics. Equal Opportunity Employer/Drug-Free Workplace PI214895048 Expected salary: Location: Toledo, OH Apply for the job now! Apply tot his job Apply To this Job