Physician Practice E&M Auditor, Educator

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

📋 Description

• The E&M Coding Auditor/Educator conducts thorough audits to assess the integrity of coding and billing for physician and clinical fees, as well as to identify and rectify documentation, coding, billing errors, and the medical necessity of billed services.

• Audits involve evaluating the precision of documentation, including E/M codes and other payer codes, medical necessity, reimbursement discrepancies, and adherence to other documentation standards.

• Researches and implements all federal guidelines and ensures compliance throughout the audit process.

• Develops and delivers comprehensive educational programs and curriculums for providers (coding resources, materials, tools, webinars, campaigns, etc.) based on audit findings, identified trends, and shifts in coding compliance and regulatory guidelines, while also supporting organizational compliance frameworks.

• Facilitates educational events for providers to present a summary of overall audit findings, highlighting trends and action plans.

• Offers support or project management for additional audit and coding initiatives and assists with other responsibilities as directed by the executive leadership team.

• Fosters positive working relationships as a subject matter expert, providing insights on risk and ensuring a comprehensive understanding of federal coding compliance requirements.

⛳️ Requirements

• Certification as a CIRCC (Certified Interventional Radiology Cardiovascular Coder) by the AAPC.

• Experience in coding interventional procedures (Cardiac Cath, EP-Electrophysiology, IVR-Interventional Radiology, IVN-Interventional Neuro).

• High School diploma, Certification, GED, Training, or relevant experience.

• AHIMA Certified Coding Specialist-Physician-based certification.

• AAPC Certified Professional Coder certification.

• AAPC Certified Professional Medical Auditor certification.

• CIRCC Certification is preferred.

• Previous experience in Physician Coding & Auditing, Revenue Cycle, or billing related to Coding.

• Upon hiring, possession of CPC-Certified Professional Coder and/or CCS-P-Certified Coding Specialist-Physician certification is required.

• CPMA-Certified Professional Medical Auditor certification must be obtained within one year of hire.

• Overall experience must include a minimum of 2 years in professional E&M coding and 2 years in E&M provider education.

• Strong understanding of E&M regulations and CMS Documentation Guidelines.

• Proven experience with data abstraction and analysis of patient encounters for focused reviews and the creation of comprehensive coding education materials and resources.

• Proficient in ICD10CM, CPT, and HCPCS coding, as well as relevant policies and procedures based on physician practices.

• Excellent organizational skills and a keen attention to detail.

• Ability to prioritize provider medical record reviews/projects and coding education opportunities in alignment with audits and overall trends.

• Capability to work independently with minimal supervision.

• Strong commitment to providing exceptional customer service.

• Excellent computer skills, with proficiency in Microsoft Office and report generation.

🏝️ Benefits

• Opportunities for career growth and development, with clear pathways and ongoing support.

• Comprehensive health and wellness resources extending beyond traditional benefits.

• A wellness program designed to assist employees in eliminating their medical plan deductible, thereby reducing out-of-pocket healthcare expenses.

• Tuition reimbursement to facilitate continued learning and advancement.

• And so much more.