Job description

Medical/Behavioral Health Auditor for PRN contract Audits

Summary of Position: PLEASE READ ENTIRE QUALIFICATIONS ALL NON-EXPERIENCED APPLICANTS WILL NOT BE CONSIDERED!!

This is a great opportunity for someone who is detail oriented and experienced in 2023 EM coding guidelines. Although there is little to no direct provider interaction, the auditor should have excellent written communication skills to deliver clear audit results. The ideal candidate will take pride in providing the best quality of work and will be available to take on auditing projects as assigned in a timely manner. This is a remote opportunity that compensates the auditor per encounter through an independent contractor agreement. There are no set hours, just project work as business dictates. The right candidate will be a subject matter expert on EM and all the recent changes to those documentation requirements.

Duties and Responsibilities:

• Audits medical or behavioral health record documentation to identify deficiencies in documentation in direct relationship to codes billed to carriers. Prepares reports of findings and clearly communicates the appropriate action plans to correct identified deficiencies.
• Must have good internet connection to utilize AAPC auditing software for EM audits and to access client data where direct access is provided.
• Upon request, researches and analyzes scenarios found in documentation to apply theory to compliance, coding, denials, and billable vs. non-billable services.
• Ensures strict confidentiality of all clients and/or proprietary company information.
• Attends coding conferences, workshops to receive updated coding information and changes in coding and/or auditing regulations.
• Performs miscellaneous auditing and coding client-related duties as assigned.

Minimum Job Requirements:

• Certified Professional Coder (CPC) and at least 3 years of experience working as an auditor.
• Certified Professional Medical Auditor (CPMA) and/or Certified Professional Compliance Officer (CPCO) designation preferred.
• Knowledge of or working with the following audit software: Audit Manager, MDAudit, Review-mate or Intellicode a plus!
• HCC knowledge a plus!!

Skill Set:

• Knowledge of auditing concepts and principles. Must be an expert at EM auditing.
• Advanced knowledge of medical and behavioral health coding and billing systems and regulatory requirements.
• Ability to use independent judgment and to manage and impart confidential information.
• Ability to analyze and solve problems.
• Strong communication and interpersonal skills.
• Knowledge of legal, regulatory, and policy compliance issues related to medical coding and auditing.
• Knowledge of current and developing issues and trends in healthcare.
• Strong written and verbal communication skills
• Must be a self-starter, able to work independently “behind the scenes” and provide best practice approach to serving clients. Reports to a Quality Analyst team lead.

Job Type: Contract

Pay: $28.00 - $30.00 per hour

Experience:

• Auditing EM Codes: 5 years (Required)

License/Certification:

• CPC, COC, CPMA or CPCO (minimum one of these) (Required)

Work Location: Remote

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