Physician Practice E&M Auditor Educator, Medical Group Auditing & Coding

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

📋 Description

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

• Identify and rectify documentation, coding, and billing discrepancies, as well as issues concerning the medical necessity of billed services.

• Assess the accuracy of documentation, including E/M and other payer codes, medical necessity, reimbursement discrepancies, and adherence to documentation standards.

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

• Create and deliver educational opportunities and curricula for providers, including coding resources, materials, tools, webinars, and campaigns, informed by audit findings, trends, and regulatory updates.

• Facilitate provider education sessions to review audit outcomes, pinpoint trends, and formulate action plans.

• Offer support or project management for related audit and coding initiatives, along with other responsibilities assigned by executive leadership.

• Act as a subject matter expert and foster constructive relationships with stakeholders to provide risk insights and maintain understanding of federal coding compliance standards.

⛳️ Requirements

• High School diploma, Certification, GED, Training, or Experience required.

• CPC-Certified Professional Coder and/or CCS-P-Certified Coding Specialist-Physician certification is required upon hire.

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

• A minimum of 2 years of professional E&M coding experience and 2 years of experience in E&M provider education.

• Previous experience in Physician Coding & Auditing, Revenue Cycle, or billing associated with Coding.

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

• Proven experience in data abstraction and analysis of patient encounters for focused review samples and development of extensive coding education materials and resources.

• Proficient in ICD10CM, CPT, and HCPCS coding, along with policies and procedures relevant to physician practices.

• Excellent organizational abilities and attention to detail.

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

• Ability to work independently with minimal supervision.

• Strong customer service skills.

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

• Minimum required experience: 4 years.

🏝️ Benefits

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

• Extensive health and wellness resources that exceed traditional benefits.

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

• Tuition reimbursement to encourage ongoing education and career advancement.