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Compliance Auditor - Profee Job in Plano, Texas

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Job Title: Compliance Auditor - Profee

Employer:CorroHealth
Type:FULL TIME, OTHER
Job Location:Remote
Skills:Profee Auditing
Specialties:Multi-specialty
Required Certifications:CPC
Preferred Certifications:CPC,CPMA
Required Experience:3 to 4 years
Preferred Experience:3 to 4 years
Location:6509 Windcrest Drive, Suite 165 Plano 75024, TX, US
* Note: This listing is for a remote position
Date Posted:11/2/2021
Responsibilities

  • Performs complex retrospective analysis of medical record documentation to identify coding and billing errors and inconsistencies according to guidelines of the AHA, CMS, AMA, Clinic Coding Clinic and CPT Assistant.
  • Analyzes audit findings to identify potential root causes of coding errors and prevent their reoccurrence
  • Provides second –level review of diagnosis, procedure and billing codes to ensure compliance with legal and procedural policies that ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices.
  • Research, analyze and respond to inquiries regarding compliance, inappropriate coding, denials and billable services
  • Provides technical support and feedback training to internal coding staff regarding coding compliance, documentation, regulatory provisions, third part payer requirements, medical necessity requirements
  • Protects the privacy and confidentiality of patient health and client information. Follows the Standards of Ethical Coding as set forth by AHIMA and adheres to official coding guidelines and compliance practices.
  • Suggests physician query opportunities query Physicians based upon documentation and clinical needs.
  • Prepare deliverables for the coders as required
  • Report work time and work productions in a timely and accurate manner
  • Communicates with coworkers in an open and respectful a manner which promotes teamwork and knowledge sharing.
  • Provide schedule of planned work activities, events and sites, and any changes to same to management and appropriate staff.
  • Maintenance of professional coding credentials and knowledge of coding, reimbursement methodologies and compliance issues through education
  • Other duties and responsibilities as assigned

Essential Functions:

Note: The essential duties and primary accountabilities below are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Incumbents may perform all or most of the primary accountabilities listed below. Specific tasks, responsibilities or competencies may be documented in the incumbent’s performance objectives as outlined by the incumbent’s immediate supervisor or manager.


Qualifications

  • Recognized coding credential from AHIMA or AAPC; and RHIA or RHIT may also be considered
  • Experience with telecommuting and electronic medical records systems strongly preferred
  • Strong analytical skills
  • Excellent written communication skills
  • Strong team player
  • Ability to work with multiple and diverse clients and projects
  • Ability to work with minimal supervision
  • 5-7 years’ experience coding and/or auditing in an acute care facility or clinic, of patient types listed in the Job Summary of this document 

 

Physical Requirements and Demands:

Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described.

Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, incumbents are subject to sitting for prolonged periods. Infrequently, incumbent must be able to lift and move material weighing up to 20 lbs. Incumbent may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.

A job description is only intended as a guideline and is only part of the employee’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate

 

Applying

Link to apply:
https://careers.corrohealth.com/united-states/jobs/1612?lang=en-us
Email: jena.ford@corrohealth.com

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