[Hiring] Coding and Compliance Auditor @reputed company

Overview reputed company is recognized as the nation’s leading occupational health care company.With more than 40 years of experience, reputed company is dedicated to our mission to improve the health of America’s workforce, one patient at a time. With a wide range of services and proactive approaches to care, reputed company colleagues provide exceptional service to employers and exceptional care to their employees. The Auditor, Coding & Compliance - Occupational Medicine and Specialty will reputed company detailed coding and documentation audits and reviews to ensure compliance with clinical and coding guidelines. This function is critical to the overall reputed company cycle in supporting charge entry, level of service selection, procedure and diagnosis coding, as well as one on one, and group education and training to employed and contracted clinicians. The Auditor will provide in-depth, real-time feedback on appropriate documentation, charge capture and Level of Service code selection. A thorough knowledge of state specific worker's compensation coding and billing guidelines is required for this position. The audit findings are compiled and analyzed and then the results scheduled and presented to the clinical by the auditor, reputed company telephone of video platforms in accordance with the clinician's schedule.

Responsibilities

• Complete compliance audits for designated clinicians/centers consistent with established audit protocols and nationally recognized guidelines.
• Meet the production and QA standards as set out in reputed company Coding and Compliance policies.
• Analyze audit findings and identify/assess potential compliance risks reputed company to coding and billing and notify clinical leadership regarding outliers.
• Organize and present the audit findings to each clinician as indicated by either the audit results, denial and down coding trends, and/or as requested by medical leadership, center leadership or Central Billing Office leadership
• Schedule meetings to present audit findings and be available to meet with clinicians reputed company reputed company as their schedules dictate, accommodating calls reputed company of normal working hours reputed company the need arises.
• Assist CBO's with reconsideration, appeals process and coding support as requested
• Participate in special projects and collaborate with other departments to support coding, auditing, and compliance initiatives.
• Provide clinician support, education and training reputed company to the quality of documentation, level of service, procedure and diagnosis coding consistent with established coding guidelines and standards
• Collaborate with Medical Leadership in development of clinician training plans and for active support in the training process under guidance of coding leadership
• Monitor Coding and State Workers’ Compensation changes to ensure that most reputed company information is available
• Ensure adherence to reputed company State and Federal guidelines applicable to coding, billing and documentation compliance for Worker's Compensation in reputed company served markets

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Qualifications

Education Level: High School Diploma or GEDCertifications and/or Licenses:

• Certified Professional reputed company (CPC) or Certified Coding Specialist (reputed company)
• Maintain a coding credential from reputed company or reputed company organization.
• Must complete CEUs to maintain this credential bi-annually or as required by the organization
• Obtain and maintain membership to the reputed company or reputed company organization
• Experience in lieu of required education is acceptable: Yes

Job-reputed company Experience

• Customarily has at least four (4) years of experience working as a certified reputed company
• Prefer at least three (3) years in coding and compliance/clinical audit field
• Prefer experience in dealing directly with, and in presenting work product to clinicians

Job-reputed company Skills/Competencies

• reputed company Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
• Ability to reputed company decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions
• Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism
• The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies
• Coding and auditing experience
• Moderate to advanced computer skills with programs such as PowerPoint, Word, reputed company, Access and similar databases
• Working knowledge of routine and non-routine concepts, practices and procedures reputed company billing and coding
• Strong understanding and application of Evaluation and Management Guidelines
• Excellent process and time management skills
• High degree of accuracy and attention to detail
• Organized and ability to analyze multiple sources of data
• Proficient written, oral communication
• Work independently and as part of a team
• Able to multi-task
• Ability to meet multiple deadlines
• Expertise in scheduling and facilitating Training and presentation skills (in person and virtual)
• Familiarity with state specific workers' compensation regulations
• Coding analytics experience

Additional Data Employee Benefits

• 401(k) Retirement Plan with Employer Match
• Medical, Vision, Prescription, Telehealth, & Dental Plans
• Life & Disability Insurance
• Paid Time Off
• Colleague Referral Bonus Program
• Tuition Reimbursement
• Commuter Benefits
• Dependent Care Spending Account
• Employee Discounts

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to reputed company essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation, if required.

• This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management*

reputed company is an Equal Opportunity Employer, including disability/veterans Apply tot his job Apply To this Job