Physician Practice E&M Auditor, Educator

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

📋 Description

• Conduct thorough audits to assess the integrity of coding and billing for clinical and physician fees.

• Identify and rectify documentation, coding/billing inaccuracies, medical necessity concerns, and reimbursement discrepancies.

• Assess the accuracy of documentation, including Evaluation and Management (E/M) codes, medical necessity, and adherence to documentation standards.

• Investigate and implement federal guidelines and compliance standards in the auditing process.

• Create and deliver educational opportunities and materials for providers, including coding resources, tools, webinars, and campaigns.

• Tailor education based on audit findings, identified patterns, and updates in coding compliance and regulatory standards.

• Facilitate educational sessions for providers focusing on audit outcomes, trends, and strategic action plans.

• Offer support or manage projects related to auditing and coding initiatives.

• Foster positive relationships as the subject matter expert and provide insights on risk and federal coding compliance obligations.

⛳️ Requirements

• High School diploma, certification, GED, training, or experience.

• AAPC Certified Professional Medical Auditor credential.

• AHIMA Certified Coding Specialist-Physician-based certification.

• AAPC Certified Professional Coder credential.

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

• Upon hire, must possess CPC-Certified Professional Coder and/or CCS-P-Certified Coding Specialist-Physician certifications.

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

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

• In-depth knowledge of E&M regulations and CMS Documentation Guidelines.

• Proven experience with data abstraction and analysis of patient encounters for focused reviews and development of comprehensive coding educational materials.

• Proficient in ICD10CM, CPT, and HCPCS coding, as well as policies and procedures related to physician practices.

• Excellent organizational skills with a keen attention to detail.

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

• Capability to work independently with minimal supervision.

• Strong customer service skills.

• Exceptional computer skills including proficiency in Microsoft Office and report generation.

• Minimum required experience: 4 years.

🏝️ Benefits

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

• Extensive health and wellness resources that exceed traditional benefits.

• A wellness program aimed at helping employees eliminate their medical plan deductible, thereby reducing out-of-pocket healthcare expenses.

• Tuition reimbursement to encourage continued learning and professional advancement.