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Virtua Health · 1 day ago

VMG Coding Auditor & Educator

Marlton, NJ

Full-time

Onsite

Mid Level

3+ years exp

Virtua Health is seeking a VMG Coding Auditor & Educator responsible for professional fee coding quality and audits, education and training for their medical group. The role includes conducting audits, providing training to coders, and resolving coding issues to ensure compliance and efficiency in coding practices.

Health Care

Responsibilities

Providing training and education for newly hired coders that includes utilizing the medical record in conjunction with rules and regulations to properly code VMG encounters

Audits new coders once they approved to submit charges in the work queues and provides appropriate feedback

Developing coding and training resources for the entire coding team (modules, scenarios, tip sheets, etc.)

Conducts Trains new coders to utilize the medical record, clinical, coding and abstracting systems, in conjunction with UHDDS and other rules and regulations and other appropriate resources to properly abstract and code all HIM coded inpatient and outpatient accounts and provides appropriate feedback

Exit interviews with external auditors, prepares rebuttals and appeals, take appropriate action with responses (including correcting data and educating providers and coders)

Responds to daily questions from VMG coders regarding correct application of coding guidelines to individual accounts

Responsible for initial onboarding education of all clinicians billing under VMG tax ID number (TIN) to include CMS 1995, 1997 and AMA 2021 Evaluation and Management guidelines

Performing chart audits to review CPT, ICD-10- CM and HCPCS codes assigned by VMG coding staff and providing timely feedback to staff and director

Overseeing the annual external audit process for all clinicians that bill under the VMG TIN by creating audit samples, communicating results to clinicians and providing annual coding education

Performing chart audits to review CPT, ICD-10- CM and HCPCS codes for clinicians who scored below 80% on their external audit

Reviewing work queue edits for provider coding trends and education needs

Confidently educates clinicians based on chart audit and coding trends

Assisting with monitoring of pre-AR aging reports

Troubleshooting and resolving complex problems with individual accounts in order to facilitate appropriate reductions in A/R and accounts held for coding

Coding charts when urgently needed to facilitate A/R goals

Working closely with Practice Directors and Practice Managers to provide efficiencies in operational workflows related to clinician coding

Working closely with VMG Practices and third party billing company to resolve coding and reimbursement issues, serves as an escalation point, and answers questions regarding coding requirements

Providing education to their staff, including clinicians and billers on pro-fee coding issues

Recommending changes to workflows to insure appropriate documentation and reimbursement

Developing policies and procedures on coding, data abstraction and compliance for VMG

Documenting and enforcing policies and procedures for VMG and provides feedback to appropriate supervisors and/or staff

Recommending changes to policies, procedures, charge master and documentation requirements to ensure appropriate reimbursement

Monitoring and reporting on productivity and quality standards

Qualification

CPT codingICD-10-CM codingHCPCS codingCPC CertificationHealthcare auditingMulti-specialty codingMicrosoft OfficeEducation presentationsPolicy developmentProblem-solving