Facility Outpatient Auditor – ED, SDS, OBS, I&I

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct thorough retrospective evaluations of medical record documentation to uncover coding and billing inaccuracies and discrepancies.

• Analyze findings from audits to pinpoint the root causes of coding mistakes and implement measures to prevent future occurrences.

• Execute second-tier assessments of diagnosis, procedure, and billing codes to ensure compliance and secure optimal reimbursement.

• Research and address inquiries related to compliance, erroneous coding, denials, and billable services.

• Offer technical assistance, constructive feedback, and training to internal coding personnel.

• Safeguard the confidentiality of patient health and client information.

• Recommend physician query opportunities and engage with physicians based on documentation and clinical requirements.

• Prepare deliverables for coding staff.

• Accurately and promptly report work hours and production metrics.

• Communicate work schedules and any changes to management and relevant staff.

• Sustain professional coding credentials and stay informed through continuous education.

• Monitor the progress and success of coding staff.

• Ensure that coder accuracy is maintained at a minimum of 95% and that QA review percentages are approximately 10%.

• Identify and address issues related to coding quality.

• Assist with systems aimed at enhancing coder productivity and coding precision.

• Provide monthly updates and status reports.

• Participate in corporate training initiatives and meetings.

• Interpret coding guidelines and evaluate the influence of documentation on code assignment and reimbursement.

• Adhere to internal policies, privacy and security regulations, ethical coding standards, and the Company’s Code of Ethics and Business Conduct.

⛳️ Requirements

• Residency in the United States is mandatory.

• A recognized coding credential from AHIMA or AAPC is required; RHIA or RHIT credentials may also be considered.

• Credentials such as CPC, COC, CCS, RHIT, or RHIA are referenced; CPC or CCS is preferred.

• Experience in ED, SDS, OBS, and I&I is essential.

• Background in inpatient/outpatient auditing and coding is necessary.

• A minimum of 2 years of coding and/or auditing experience for inpatient and outpatient facilities is required; preferably 3 years.

• At least 1 year of customer service support experience is necessary.

• Familiarity with hospital outpatient billing processes is expected.

• Understanding of hospital APC assignment along with relevant coding and documentation is required.

• Experience with telecommuting and electronic medical record systems is highly preferred.

• Strong analytical abilities are essential.

• Excellent verbal and written communication skills are required.

• Proficiency in Microsoft Office applications, particularly Word and Excel, is necessary.

• Ability to navigate various EMR environments and review handwritten charts is required.

• Capability to prioritize tasks, meet deadlines, and uphold quality and accuracy is essential.

• Ability to work with a diverse range of clients and projects is expected.

• Capacity to work independently with minimal supervision is essential.

• Regular, predictable, and punctual attendance is required.

• Initiative, resourcefulness, and meticulous attention to detail are necessary.

• Strong teamwork skills are essential.

🏝️ Benefits

• Opportunities for professional development and personal growth.

• Training and education provided by the company.

• Reasonable accommodations for individuals with disabilities.

• Flexible remote work arrangement.