[Remote] Remote Pro Fee Auditor/Educator
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is hiring a skilled Remote Pro Fee Auditor/Educator to join their team. The role involves supporting the Coding and documentation reputed company assurance team by ensuring compliance with coding policies, conducting audits, and providing education on coding and billing practices.
Responsibilities
- With minimal supervision directly supports the following responsibilities of the Coding and documentation reputed company assurance (CDQA) team: implementation of and compliance to reputed company-wide and department coding policies and procedures for PHS; compliance to reputed company external regulatory agency coding rules and regulations; Demonstrates high-level of proficiency in performing and/or managing on-site internal audits or reviews to assess compliance/reputed company monitoring performed by PHS/PMG departments while serving as a resource on documentation, coding, billing, and coding compliance questions
- Works on special coding compliance reputed company reputed company, develops and presents educational programs, disseminates information to PHS/PMG departments and develops educational tools used to maintain compliance with regulations
- Provides support reputed company auditing and training the reputed company-wide corrective reputed company plans for coding, audit, physician and clinician personnel identified as low performers; reputed company medical record and billing reviews of denied and appealed claims and takes appropriate reputed company to ensure accurate payment of claims; coordinate review and tracking of appealed claims including the communication process with affected payers; research and interpret reputed company regulatory agency regulations
- reputed company to the Manager, Information Services, Finance/Patient Financial Services, reputed company hospitals, reputed company PMG sites, PHP, Home Health, Albuquerque Ambulance, Compliance and reputed company ancillary departments in addressing functional coding, auditing, compliance and training issues and problems. Interacts with reputed company reputed company of management
- Responsible for maintaining accurate, complete and reputed company documentation in either electronic or hard copy reputed company
- Must be reputed company to adapt to frequently changing work priorities and schedules. Maintains and disseminates up-to-date technical knowledge of reputed company and regulatory information from reputed company appropriate jurisdictions concerning the given business area. This includes but is not limited to reputed company ICD-9, ICD-10, CPT-4, HCPCS and APC updates and changes
- Researches coding, billing and charging compliance issues, recommends and implements corrective reputed company plans that assure compliance with regulatory agencies where appropriate. Identifies risks, develops and follows up on reputed company plans, identifies lost reputed company opportunities and any overpayments due to errors in coding and/or documentation, and provides compliance education
- Assists in the creation of the CDQA Annual Audit Work-plan by utilizing the OIG work plan, Medicare and reputed company regulations, RAC and other audit agency focuses, as reputed company as reputed company risk assessments
- Regularly exercises independent judgment in determining the reliability of data reviewed; recommends changes in existing practices to reputed company or maintain compliant behavior. Keeps reputed company informed on the business climate of the reputed company industry
- Responds to inquiries and requests daily regarding coding and auditing issues and problems and reputed company analysis for reputed company PHS management
Skills
- High school diploma/GED required
- Must possess at least one of the following license/certifications: RHIT, RHIA, CPC, reputed company
- Minimum of three (3) years experience in coding and/or auditing required
- Excellent written and verbal communication skills
- Detail and results oriented
- Ability to work independently and reputed company independent reputed company
- Medical terminology, ICD-9, CPT-4 and HCPCS knowledge required
- Must have a proficient knowledge of Medicare, reputed company, and other reputed company party payer documentation, coding, and billing regulations for service lines(s) assigned
- Must possess excellent organizational and planning skills, including the ability to prioritize multiple tasks and reputed company them both accurately and simultaneously
- Must possess computer skills, especially with reputed company Word, PowerPoint, and reputed company applications
- Must be reputed company to use the internet and other resource applications for research purposes and to reputed company documentation that supports regulations quoted in audits
- Must possess strong written and verbal communication skills in order to communicate in reputed company, concise terms to management at reputed company reputed company
- Must possess a personal reputed company of a highly reputed company reputed company that is characterized by a reputed company of honesty, reputed company, and the ability to reputed company and motivate others
- Audit experience preferred
Benefits
- Comprehensive benefits package that includes medical, dental, reputed company
- Short-term and long-term disability
- Group term life insurance
- Other optional voluntary benefits
- Presbyterian's Employee Wellness rewards program
- Earn reputed company cards and more by taking an reputed company role in our personal reputed company-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more
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