Serves in a consulting
role by evaluating the work of client’s coder and providers in their assignment
of ICD-10, CPT and/or HCPCS codes for professional services. Performs
concurrent or retrospective reviews to inventory code assignments and report
the data to the client. Develops and delivers educational content
to clients related to audit findings.
high quality audits for both hospital owned and physician owned practices as it
relates to the ambulatory setting or professional services rendered in hospital
for auditing and providing constructive feedback to clients.
o Reviews patient charts and makes
recommendations regarding coding, documentation, and reimbursement to identify
errors and inconsistencies, under coded and up coded services as recognized by
the AHA, CMS, AMA, AHIMA, Coding Clinic, and CPT Assistant.
findings and identify potential root causes of produced errors.
summary reports of findings to clients, supplying specific references
supporting findings contained within the provided audit report.
for delivering the healthcare education programs related to professional
services and practice management to include creation of training programs for
physicians, mid-level providers, practice managers and staff of physician and
hospital owned ambulatory services.
focus will evolve and adjust depending upon the needs of the client and may
relate to ICD-10, CPT, HCPCS, 95, 97 and 2021 Guidelines.
Audits as assigned meeting the productivity standards as set by record type for
each audit. The threshold for billable productive hours, when client work is
available, is expected to be at or above 80%.
independent QA of their assigned audit results prior to final submission for QA
review and approval. The minimum accuracy expectation is 95%.
all situations, protect the privacy and confidentiality of patient health and
client information, and follow the Standards of Ethical Coding as set forth by
AHIMA and adhere to official coding guidelines and compliance practices,
standards, and procedures.
the ability to discuss and clarify questions related to documentation, patient
clinical needs and related coding with providers.
Essential Duties and
deliverables for the client as required
communication and presentation skills
time management skills with ability to work independently and know when to seek
support from supervisors
flexible, efficient, and able to perform effectively in stressful
a section of work from simple to complex. Understand the scope of the
to effectively manage more than one assignment at a time and organize and
prioritize work to meet client needs and timelines
work time and work products in a timely and accurate manner
with coworkers in an open and respectful manner that promotes teamwork and
with clients in a professional manner that, at all times, exhibits excellent
relationship, work performance and communication skill so as to support the
company and its business interests
schedule of planned work activities, events and sites, and any changes to same,
to Management and appropriate staff
of professional credentials and knowledge of coding, reimbursement, and compliance
issues through continuing education.
travel, as required.
duties and responsibilities, as assigned.
Desired Minimum Qualifications
years’ experience coding and/or auditing in an acute care facility or clinic,
of patient types listed in the Job Summary of this document, or other relevant
coding credential from AHIMA or AAPC; RHIA or RHIT may also be considered.
Experience with telecommuting and electronic medical record systems strongly
Ability to work with multiple and diverse clients and projects
Possess extensive knowledge of medical and health care policies and
Effective command over verbal and written communication with good interpersonal
Ability to train and mentor
Strong team and collaborative
Strong supervisory, organizational and management background
related to physician practice
Proficient computer skills, specifically Microsoft Office products.