The Physician Documentation/Coding Auditor will ensure coding and billing compliance through ongoing audits and education of physicians, staff, and clinic sites. Under general supervision, using a combination of regulatory, coding, documentation and billing knowledge, the Physician Documentation/Coding Auditor will complete scheduled audits of assigned providers at designated intervals.
The auditor will also monitor and aid in improving the quality of documentation related to the requirements to bill for services provided. The Physician Documentation/Coding Auditor will compare clinical and financial records to ensure that the documentation provided supports the patient charges listed. The audit will flow to claims and the auditor will ensure that the claim for services was billed to the payer correctly. If the PDCA detects errors, the Auditor will present corrected information to Billing Compliance and/or the affected department(s) as instructed, and work collaboratively to maintain accurate and appropriate coding and billing.
- CPC, CPC-H or CPMA Certification at time of hire
- High School Diploma; Tech/Vocational school or College preferred
- 3-5 years clinical coding experience (ICD-9, CPT-4, and HCPCS) or combination of applicable experience and education
- Proficient in Excel, Word, Data Entry, computerized health care billing software knowledge
- Excellent organizational and analytical skills.
- Extreme attention to detail with ability to prioritize assignments to meet deadlines.