Auditor/Educator
Where
- Charlotte, NC
What you'll be doing
- Maintains a working knowledge of the ICD-9-CM, ICD-10-CM and CPT/HCPCS coding principles and the AMA/CMS documentation guidelines (DGs); keeps current on any changes to payer-specific reimbursement policies; acts as a coding resource to his/her assigned practices and the CBO, responding to inquiries on a timely basis. Routinely conducts provider chart reviews and performs at the other reviews, as needed, to understand how a provider selects his/her diagnosis, procedure and evaluation and management (E/M) codes and to offer advice about the application of the AMA/CMS DGs; provides written reports with review findings to leadership; provides follow-up education based on review findings. Reviews and analyzes denial information from third party payers to understand reasons for denials; coordinates with practice management and the CBO to address operational issues that are contributing to the denials; reviews denials received from the RAC (recovery audit contractor); writes appeal letters as indicated. Monitors regulatory and reimbursement information to keep informed of relevant changes/updates.
What your background should be
- Ability to sit and concentrate for extended periods of time. Frequent reaching and handling of reports and/or medical records. Healthcare consulting preferred. CPC, CCS-P, RHIT or RHIA credential required. CEMC required or must be obtained within first year of employment. Minimum of 5 years coding experience required. Knowledge of medical terminology and anatomy and physiology required.
Required Schooling / Training
- HS diploma or equivalent required. Bachelor degree preferred.
Who is the client company
- Concern about hospital & health care services.
- If you are interested in this position, send your resume to apply@kochdavis.com
