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Coding Compliance HCC Auditor Job in Berkeley Heights, New Jersey

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Job Title: Coding Compliance HCC Auditor

Employer:Summit Medical Group
Type:Salaried Full-Time
Skills:An understanding of coding concepts,AMA,CMS/OIG/Federal/State regulations and guidelines,along with other risk adjustment reporting measures will be expected
Required Certifications:RHIT or RHIA,CPC,CRC,CCS-P,CCA
Preferred Certifications:CHC,CPMA,CCP-P,CPPM,CPCO,CEMC
Required Experience:1 to 2 years
Location:Berkeley Heights, NJ
Date Posted:8/30/2018

Coding Compliance HCC Auditor

Berkeley Heights, NJ

 

At Summit Health Management (SHM), our goal is to positively impact the quality and availability of health care across the country while ensuring the continued vitality of patient-centric, physician-owned and governed medical groups. Established in 2014 by the physician owners of Summit Medical Group (SMG), one of the largest and most highly regarded independent multispecialty medical groups in the nation, SHM drives performance enhancements for its partners by providing expertise in organizational structure and governance, operations, revenue cycle management, physician management, population health management and other administrative and clinical functions.

 

As an integral member of our Coding Compliance Department, and reporting to the Supervisor of National HCC Services, you will oversee both internal (scheduled, focused and project driven) and external audits for the purpose of monitoring compliance to final resolution. In addition, you will review medical records for proper assignment of diagnoses, as well as ensure diagnosis reporting meets all AMA, ICD-10-CM, HCC, Risk Adjustment Reporting, and CMS Guidelines per in-house process.

 

Responsibilities include:

 

·         Utilizing a risk-based audit approach and establishing preliminary scope of reviews, as well as incorporating patterns and trending analysis based on performing reviews

·         Providing education to physicians and staff on appropriate documentation needs

·         Maintaining a high level of specialty specific coding and auditing guidelines

·         Utilizing logs to identify and communicate patterns and trends found in audit reviews

·         Conducting audit reviews related to Coding Compliance initiatives and communicating audit outcomes to management, along with educational areas of opportunity

·         Researching and providing timely response to inquiries from physicians relating to HCC Risk Adjustment projects and reports

·         Providing detailed comments/feedback on physician performance based on retrospective chart reviews

·         Working with management to create individual provider education plans

·         Assisting management with special HCC projects

·         Handling other related functions as necessary

 

To qualify, you must have an Associates’ Degree (Bachelor’s preferred), Medical Coding Certificate, and 2 years of related work experience that includes at least 1 year of auditing experience, and preferably, prior supervisory experience. An understanding of coding concepts, AMA, CMS/OIG/Federal/State regulations and guidelines, along with other risk adjustment reporting measures will be expected, as will proficiency in the use of HCC and ICD-10 auditing concepts. Coding Certifications (CRC, CPC, CCS-P, CCA, RHIT or RHIA), and the ability to meet productivity standards and turnaround times are a must. Excellent analytical, problem-solving, oral/written communication, and PC (Excel, Word, PowerPoint) skills essential. Any auditing, compliance, billing or practice management certifications (CEMC, CPCO, CPMA, CCP-P, CHC, CPPM, etc.) preferred.

 

We offer a competitive salary, comprehensive benefits package, and a dynamic working

environment. For immediate consideration apply online at:

 

https://recruiting.adp.com/srccar/public/RTI.home?c=1152451&d=Summit_Health_Management&r=5000405996006&_fromPublish=true#/

 

Summit Health Management

https://jobs.summithealthmanagement.com/

 

We are a smoke and drug-free environment. EOE M/F/D/V

 

 

Applying

 

We offer a competitive salary, comprehensive benefits package, and a dynamic working

environment. For immediate consideration apply online at:

 

https://recruiting.adp.com/srccar/public/RTI.home?c=1152451&d=Summit_Health_Management&r=5000405996006&_fromPublish=true#/


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