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Auditing & Education Consultant, Physician Services Job in Plano, Texas

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Job Title: Auditing & Education Consultant, Physician Services

Required Certifications:CPC
Preferred Certifications:CPC,COC,RHIT,CPMA,RHIA
Required Experience:3 to 4 years
Preferred Experience:5 to 7 years
Location: Plano 75024, TX, US
Date Posted:12/16/2020

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. 

Essential Functions:

·       Conduct high quality audits for both hospital owned and physician owned practices as it relates to the ambulatory setting or professional services rendered in hospital settings. 

·       Responsible 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.

·       Analyze findings and identify potential root causes of produced errors.

·       Prepare summary reports of findings to clients, supplying specific references supporting findings contained within the provided audit report.

·       Responsible 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.

·       Educational 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.

·       Conduct 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%.  

·       Conduct independent QA of their assigned audit results prior to final submission for QA review and approval. The minimum accuracy expectation is 95%.

·       In 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.

·       Possesses the ability to discuss and clarify questions related to documentation, patient clinical needs and related coding with providers.

Essential Duties and Responsibilities

·       Prepare deliverables for the client as required

·       Excellent communication and presentation skills

·       Excellent time management skills with ability to work independently and know when to seek support from supervisors

·       Very flexible, efficient, and able to perform effectively in stressful situations. 

·       Manage a section of work from simple to complex.  Understand the scope of the total project

·       Ability to effectively manage more than one assignment at a time and organize and prioritize work to meet client needs and timelines

·       Report work time and work products in a timely and accurate manner

·       Communicates with coworkers in an open and respectful manner that promotes teamwork and knowledge sharing

·       Interact 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

·       Provide schedule of planned work activities, events and sites, and any changes to same, to Management and appropriate staff

·       Maintenance of professional credentials and knowledge of coding, reimbursement, and compliance issues through continuing education.

·       Periodic travel, as required.

·       Other duties and responsibilities, as assigned.

Desired Minimum Qualifications

·       5+ 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 experience.

·       Recognized 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 processes   

•   Effective command over verbal and written communication with good interpersonal skills.       

•   Ability to train and mentor others          

•   Strong team and collaborative skills      

•   Strong supervisory, organizational and management background related to physician practice management        

•   Proficient computer skills, specifically Microsoft Office products.



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