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Profee Coding Compliance Auditor Job in Frisco, Texas

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Job Title: Profee Coding Compliance Auditor

Employer:Conifer Health Solutions
Job Location:Remote
Specialties:Experience across multiple specialties is preferred
Required Certifications:CCS-P,CPC
Required Experience:3 to 4 years
Preferred Experience:5 to 7 years
Location:7624 Warren Pkwy Frisco 75034, TX, US
* Note: This listing is for a remote position
Date Posted:8/19/2021
  • Understands, interprets and applies coding guidelines for coding audits ofmulti-specialty professional encounters. Performs medical record reviews to determine coding accuracy of evaluation and management services, surgical and office-based procedures, and diagnosis codes. Validates compliance with non-physician practitioner billing, teaching physician and scribe services, as applicable. Conducts overall claims review to validate reporting accuracy of codes impacting professional reimbursement including, but not limited to, CPT, ICD-10-CM, HCPCS, Modifier and POS.
  • Creates clear, concise and accurate audit findings and recommendations in written audit reports that will be used for advising and educating Healthcare Providers, Coders, Auditors, Managers, and Directors throughout the organization.
  • Identifies documentation issues (lacking documentation, split/shared visit services, etc.) that impact coding accuracy. Clearly communicates (verbally and in written reports or summaries) opportunities for documentation improvement related to coding issues.
  • Stays current with CMS, AHA, AMA/CPT and ICD-10-CM Official Coding and Reporting Guidelines, and other agency directives for professional fee coding. Completes online education courses and attends mandatory coding workshops and/or seminars (MPFS, IPPS, and OPPS, ICD-10-CM and CPT updates) for all coding types.. Reviews AHA and CPT quarterly coding update publications. Attends all internal conference calls for Quarterly Coding Updates.


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