Audit and Coding Consultant

Responsibilities

• Audit and develop educational materials regarding coding/documentation guidelines.
• Educate providers and coders about coding/documentation guidelines.
• Research regulations on new codes and identify opportunities for growth.
• Ensure accuracy and completeness of coding through a rigorous quality review of external and internal documentation.
• Review reimbursement deficiencies and improve processes.
• Ensure appropriate services are provided in accordance with examination protocols and medical billing.
• Work with vendors to maintain audit processes and provide feedback to both vendor and physicians.
• Identify unusual examiner patterns and deficiencies in the reimbursement process.
• Create and execute provider education for individuals and/or group sessions.
• Maintain audit results and ensure provider movement throughout the compliance audit plan.
• Analyze and confirm external results, working with senior leadership and compliance to create action plans.
• Research guidelines and regulations for proposed lines of business.
• Keep revenue cycle and physicians updated on new or changing regulations.
• Work with IT to ensure codes are updated and build for new services include required data points.

Qualifications

• Associates or 2 years' work related experience
• Bachelor's degree preferred
• 3 years revenue cycle experience required
• 3 years professional coding experience required
• 5 years coding leadership experience or equivalent preferred
• Certified Coding Audit Professional (CCAP) certification required
• Certified Professional Coder (CPC) certification required