Physician Audit-Educator

Responsibilities

• Perform prospective and retrospective audits of patients’ charts to ensure compliance with all applicable regulations and standards.
• Provide coding and documentation support through one-on-one visits, phone calls, and WebEx sessions.
• Create specialty or individual provider tip sheets.
• Offer guidance and advice for reporting policies mandated by government entities and other payers to ensure accurate documentation.
• Respond to payor audits conducted by CMS RAC contractor, Medicare, Medicaid, and other payors.
• Analyze data, communicate findings, and facilitate improvement efforts with providers.
• Develop and maintain educational materials and training programs, independently or collaboratively within the department.
• Consider remote employment opportunities.

Qualifications

Requires a Bachelor’s degree in healthcare, medical records, or a related field. A Master’s degree is preferred. Relevant work experience in healthcare documentation and compliance is required. Proficiency in coding and documentation standards is essential. Strong analytical and communication skills are necessary. Experience with CMS RAC audits and payor compliance is beneficial. Ability to work independently and collaborate effectively is required.