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Auditor Job in New York, New York

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Job Title: Auditor

Employer:The Marwood Group
Type:FULL TIME
Job Location:Remote
Skills:Healthcare coding/auditing,Identify Fraud,Waste and Abuse,EMR Systems
Specialties:Medical, Behavioral Health, Chemical Dependency, OBGYN, Ophthalmology Dermatology, ASC, Radiology, etc.
Required Certifications:CPC
Preferred Certifications:CRC,COC
Required Experience:5 to 7 years
Location:733 Third Ave 11th Floor New York 10017, NY, US
* Note: This listing is for a remote position
Date Posted:1/12/2021
The Marwood Group, a NYC based healthcare consulting firm, is looking for candidates to join its Clinical and Compliance Team

Coding Audit Associate

  • Full Time Position NYC based or work remotely
  • Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers

Minimum Qualifications:

CPC with a minimum 5 years’ experience in healthcare coding/auditing (E&M, CPT, HCPCS and ICD-10,), with knowledge of professional billing, coding and documentation practices performed by physicians and other qualified healthcare providers in inpatient and outpatient settings

     Proficiency in evaluating how well clinical documentation supports medical necessity and the E/M, CPT and HCPCS codes that were billed, across a wide range of services, including medical, behavioral health, chemical dependency, OBGYN, Ophthalmology Dermatology, ASC, Radiology etc.

     Proven ability to identify billing and coding issues including use of Modifiers, bundling issues, CCI edits, therapeutic and diagnostic procedures, supplies, materials, injections, drugs, modifiers, and units of service etc.

     Solid understanding of state and federal coding, and documentation laws and regulations, applicable fraud statutes and regulations, and federal guidelines on recoupments and other anti-FWA activity. Identify and access risk of prepayment or recoupment in the event of payor scrutiny

     Knowledge of anatomy, physiology, and medical terminology necessary to appropriately review assignment and documentation of diagnosis codes

     Familiarity with and ability to work within EMR systems

     Highly organized with a high level of attention to detail and task management

     Ability to work in a fast paced and rapidly changing environment

Additional Desired Skills:

     Additional certification applicable to this work includes:

  • Certified Outpatient Coder (COC™)
  • Certified Risk Adjustment Coder (CRC)

     Experience with HIPAA, data privacy, and/or data security processes

     Experience working with regulators governing (public or private) health insurance carriers 

Compensation package is commensurate with experience. There is no travel expected with this position. 


Applying

Please send resume as an attachment to:

Pcrocker@marwoodgroup.com

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