Wiki CPC-A in auditing position

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Darlene1960

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Hello. I recently started a new position as an auditor. I have been with the company for three years in billing, then applied for the auditing position and got the job. I am auditing coding and learning about third party audits, etc. so was wondering if anyone has been in this situation where they are auditing coders and other third party audits but does not have any coding experience other than passing the CPC exam. FYI - I also have previous experience with insurance as I worked for a health plan for 30 years.
 
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I really question this. I have coded most specialties over the years and have coded orthopedic surgeries for the past ten years. Passing the CPC exam started me on the right path to be able to do all of that, but passing the exam does not mean that you can look at a note and make a decision on whether the note supports the coding or not. Billing gets you a bit more familiar with codes and combinations, but not enough for auditing purposes. I was lucky enough to sit down the outside auditors as they audited my clinics and gave me valuable information as a coder. Due to that experience I was able to code E/M very accurately. As a biller your probably familiar with how certain insurance companies may want to be billed. I wish you well.
 
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Orthocoderpgu said:
I really question this. I have coded most specialties over the years and have coded orthopedic surgeries for the past ten years. Passing the CPC exam started me on the right path to be able to do all of that, but passing the exam does not mean that you can look at a note and make a decision on whether the note supports the coding or not. Billing gets you a bit more familiar with codes and combinations, but not enough for auditing purposes. I was lucky enough to sit down the outside auditors as they audited my clinics and gave me valuable information as a coder. Due to that experience I was able to code E/M very accurately. As a biller your probably familiar with how certain insurance companies may want to be billed. I wish you well.
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I am shadowing so I'm not out there by myself so I am learning the coding side of it.
 
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