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GI Alliance · 2 weeks ago

Coding Auditor & Provider Educator

United States

Full-time

Remote

Mid Level

3+ years exp

GI Alliance is seeking an experienced Coding Auditor & Provider Educator. The Compliance Auditor I will be responsible for researching and analyzing medical records, validating coding, and preparing reports that summarize audit findings and provide recommendations for corrective actions as needed.

Health CareMedical

Responsibilities

Conducts physician chart audits to identify incorrect coding and prepares reports of findings and issues

Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control

Reports coding patterns identified within the audit process to the Director and identifies corrective measures to problems

Provides second-level review of organization’s billing performance to ensure compliance with legal and procedural policies and adherence to regulations that pose risk

Provides feedback to providers regarding billing and documentation policies and procedures and educates on conflicting or non-specific documentation

Performs quality assessment of records, including verification of medical record documentation (both electronic and handwritten)

Abstracts and assigns the appropriate ICD-10, HCPCS/CPT codes, including Level I & II modifiers, as appropriate for all diagnosis and procedures performed in outpatient and inpatient settings

Maintains current knowledge of coding guidelines and relevant federal regulations using current CPT, HCPCS II, and ICD-10 materials, the Federal Register, and other pertinent materials

Manages time effectively to meet all required deadlines for operational and department needs

Collaborates in a team environment with the Department Director and other staff regularly

Enhances professional growth and development through in-service meetings, educational programs, conferences, etc

Performs other related duties as required and assigned

Qualification

Certified Professional Coder (CPC)ICD-10 codingHCPCS II codingCPT codingEvaluationManagement codingGastroenterology codingMicrosoft ExcelMicrosoft WordMicrosoft PowerPointInterpersonal skillsWritten communicationVerbal communication