Who We Are:
LW Consulting, Inc. (“LWCI”) is a fast-growing consulting company. The company provides
management, consulting and strategic advisory services to the healthcare,
government and technology industries. The
Auditor and Compliance Consultant is typically the lead consultant on client
project teams, provides consulting to our clients and may serve as the project
manager on engagements. To learn more about us, please visit us at https://www.lw-consult.com/
About the Role:
This position may be located in the Harrisburg office, or remote in the Eastern Standard Timezone.
The Auditor and
Compliance Consultant is responsible for delivering appropriate,
well-supported, and thoroughly-documented decisions which may result in the
identification of improper payments (overpayments and underpayments) on paid
claims, or an opportunity to enhance revenue based on appropriate
documentation. The consultant will independently research and provide citations
for medical necessity, documentation, coding and billing determinations and
will provide written substantiation for appeals, including options for curing
or improving compliance.
The consultant
must be comfortable in teaching and presenting in front of large and small
groups including in front of professional associations. The consultant will be responsible for
leading training for new providers, annual education to physicians, and other
education programs in person as well as by webinar.
Areas of
consulting focus vary from project to project, but many client engagements
focus on Outpatient and Inpatient services such as: Urgent Care, OB/GYN, Internal Medicine,
Hospitalist, Orthopedic, Emergency Services, Anesthesia, Pain, Clinical Lab,
Radiology, Cardiovascular, Oncology and other Outpatient services. Additionally, the Auditor and Compliance
Consultant may be assigned projects which focus on: payer contracting matters,
various regulatory compliance issues, client operations, the financial impact
of coding and billing issues, and revenue integrity analyses.
Core duties and
responsibilities include the following.
Other duties may be assigned.
- Conducts operational assessments and coding.
- Documents and bills audits and appeals of various medical
specialties on a case by case and client-directed basis. During such reviews, the Auditor and
Compliance Consultant will assess ICD-9 / ICD-10 and CPT / ASA and E&M
coding and billing to ensure accuracy and appropriateness, as well as
compliance with government regulations (professional and facility).
- Lead training for new providers, annual education to physicians,
and other education programs in person as well as by webinar.
Education and
Experience:
- Associate
degree in Medical Coding
- Bachelor’s
Degree is preferred
- 5+
years of relevant work experience in as a Medical Coder
- Certified
Professional Coder (Physician) - CPC-P OR Certified Coding
Specialist - CCS-P, OR Certified Risk Adjustment
Coder (CRC) are highly preferred
- Experienced
in working remotely
- Consulting
experience a plus
Required Abilities
and Skills:
- Strong interpersonal, verbal, and written communication skills
- Ability to work independently and as a member of a team
- Ability to work via telephone with remote team
- Flexibility to work in a changing environment
- Strong Microsoft Office skills, strong computer skills
- Ability to thrive in a fast-paced environment
- Promoting a positive Company culture, atmosphere and “team-player”
attitude
- Quickly gain knowledge of LWCI Company Goals, Standards, Policies
and Procedures
Company Offers:
- Salary will be commensurate with experience and education
- Comprehensive benefits package available including: Healthcare Insurance, Paid Vacation &
Holidays, 401k, Profit Incentive Plan, and Growth Opportunities