Senior Compliance Coding Auditor
Medical Faculty Associates, Inc

Washington, District of Columbia

Posted in Medical and Nursing


This job has expired.

Job Info


Position Summary

Under limited supervision, conducts annual and periodic audits of coding and documentation of procedures and services performed by MFA physicians. Follows policies of CMS, AMA and commercial carriers to assure consistent quality and adherence to coding principles and documentation requirements. Provides ongoing training and acts as resource person to physicians, non-physician providers, support staff, administrators and other personnel on third party payer documentation and coding requirements.

Essential Duties and Responsibilities: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.

  • Audits documentation and coding to include, but not be limited to, inpatient and outpatient progress notes, operative reports, encounter forms, and other documentation of procedures and ancillary services performed by physicians and non-physician providers.
  • Audits coders and auditors to insure compliance with federal, state and third-party insurer rules and regulations and note trends.
  • Prepares written reports of audit findings and recommends corrective actions plans as needed and appropriate.
  • Educates coders, auditors, providers and non-physician providers on error trends and how to prevent/reduce errors to maximize reimbursement and demonstrate compliance.
  • Meets with coders, auditors, physicians and non-physician providers to provide findings and education.
  • Participates in educational and training programs to ensure correct documentation and coding and adherence to the MFA Corporate Compliance Program.
  • Maintains working knowledge of CMS (Medicare and Medicaid) regulations and Novitas Local Medical Review Decisions (LCD) and National Review Decisions (NCO). Familiarity with AMA Coding Guidelines, and AHA guidelines. Reviews insurance carrier bulletins and healthcare industry periodicals.
  • Correctly prioritizes own activities in accordance with outstanding audit projects and other work demands. Remains flexible and ready to assume additional responsibilities as needed.
  • Demonstrates diligence, independence and initiative, acts as resource to other compliance department auditors, coders, providers, non-physician providers and staff.
  • Performs other duties as assigned.
Qualifications

Education
  • A high school diploma or an equivalent level of education is required.
  • A CPC or CCS-P coding certification is required.
  • An Associate's degree in HIM is preferred.
Experience
  • A minimum of 3 years in professional medical auditing is required.


This job has expired.

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