Physician Coder/Auditor

POSITION PURPOSE

• Areas of emphasis will include inpatient and outpatient coding of provider charges as well as documentation reviews and audits. Secondary responsibilities will include assisting Physicians Billing staff and clinic staff with coding questions.

MINIMUM EDUCATION REQUIRED

• High School or Equivalent (GED)

MINIMUM EXPERIENCE REQUIRED

• 1-3 years Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or Certified Coding Specialist – Physician (CCS-P) MINIMUM EXPERIENCE PREFERRED

LICENSES / CERTIFICATIONS REQUIRED

• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or Certified Coding Specialist – Physician (CCS-P).

KNOWLEDGE, SKILLS & ABILITIES REQUIRED

• Knowledge of CPT and ICD-10 codes

• Ability to accurately audit provider documentation to ensure all CPT codes and ICD-10 codes are accurately assigned

• Ability to communicate findings by way of written reports and via verbal communication with provider(s) and management staff

• Proficient computer and typing skills and familiarity with Microsoft programs such as Word and Excel

• Ability to understand and interpret policies and regulations

• Ability to read and interpret clinical documentation

• Ability to write, hear, and speak the English language

PRINCIPLE ACCOUNTABILITIES AND ESSENTIAL DUTIES

• Responsible for conducting internal monitoring and auditing of provider documentation.

• Responsible for communicating audit findings to the provider(s), and/or appropriate management staff by way of written or verbal reports.

• Responsible for monitoring provider’s compliance with the auditing program and reporting noncompliance to the appropriate individual.

• Responsible for reviewing all insurance guidelines to ensure coding/documentation compliance.

• Responsible for acting as a resource for Physicians’ Billing and Clinic staff with issues related to documentation and/or compliance.

• Responsible for interacting with physicians to clarify diagnoses or procedures.

• Responsible for seeking out resources, including appropriate management staff, for questions or other issues.