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Compliance Auditor II Job in Lakeland, Florida

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Job Title: Compliance Auditor II

Employer:Watson Clinic LLP
Type:Full-Time
Required Certifications:CRC,CPC
Required Experience:5 to 7 years
Location:Lakeland, FL
Date Posted:10/10/2018

Essential Functions
Assists in oversight of the department for review activity and deadlines, training of staff, input for employee evaluations, and ensures department audit goals are met. Also generates and reviews pivot tables for procedures.

Conducts chart reviews of medical records for outpatient/inpatient providers. Reports on documentation to support CPT and ICD10 codes and RAF reviews. Provides timely provider communication by memo and telephone. Identifies deficiencies and educational needs of provider. Reports clear and detailed recommendations to improve documentation of level of service billed specificity of ICD10 codes and RAF scores. Determines the level of inservice education needed for providers. Communicates credible and concise findings in provider reports. Presents in a professional, organized and positive manner.

Demonstrates a contribution to the department’s operation and goals/targets for the year. Maintains monthly log of activity, Completes 10 charts/quarter for assigned providers. Conducts reviews within the department production rate determined on an annual basis. Prioritizes workload maintains control over interruptions.

Demonstrates ability to use auditing software program, IDX system, LCD and local hospital resources to conduct reviews and summary of findings. Ability to use the TES program in IDX for retrospective or concurrent reviews. Pursues medical records needed from outside resources (i.e. SNF, other hospitals)

Identifies departmental process discrepancies during review process. Compiles monthly documentation of keying errors by provider, DOS, MRN and batch number. Reports any operational areas of risks identified. Recommends improvements to encounter forms. Reports treatment inconsistencies for review.

Identifies departmental process discrepancies during review process. Compiles monthly documentation of keying errors by provider, DOS, MRN and batch number. Reports any operational areas of risks identified. Recommends improvements to encounter forms. Reports treatment inconsistencies for review.

Adheres to guidelines set by the clinic’s Compliance Program and Audit policy and procedures  

Required Education and Experience: High School diploma or equivalent and a minimum of 5 years coding/healthcare reimbursement experience. Certification by American Academy of Professional Coders (CPC) for a minimum of 5 years or equivalent organization and CRC (Certified Risk Coder). CRC certification must be obtained within 3 months. Must have advanced knowledge in medical terminology and anatomy. Must have advanced knowledge of insurance reimbursement, principles and practice. Must have knowledge of computer and Microsoft Office. 

Applying

www.watsonclinic.com

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