ProFee Medical Coding Auditor - REMOTE POSITION Job in Remote Position, Tennessee

Overview:             Under the direction of the Mgr. of Audit, the IR ProFee Auditor performs coding and/or clinical documentation integrity audits to ensure compliance with Federal and State Regulations

Job Tasks: 

 ·     The reviewer will identify cases coded incorrectly and provide feedback and supporting documentation for changes to the coder.

·     Utilize only recognized official coding resources when performing reviews.

·     Perform coding both concurrent, prebill and retrospective according to auditing schedule.

·     Audits for appropriate clinical documentation to support diagnosis capture and to ensure the level of service rendered to all patients is recorded.

·     Serves as an expert resource in reviewing all medical records in support of consistent documentation for all payer types (i.e. CMS, Medicare-Advantage, etc.) to ensure complete and accurate diagnosis capture, coding and queries.

·     Provides recommendations for improvement and suggestions for better quality and compliance.

·     Maintain productivity based on type of cases reviewed and quality standards.

·     Complete audits within established timeframes.

·     Completion and follow through of all processes entailed in reviews and client obligations utilizing reviewer’s own initiative.

·     Reviewer to adhere to ‘Standard Terminology for Quality Reviewer Recommendations’ Policy

·     Other duties as assigned

·     Prepare and maintain a productivity log.

Systems

·     Experience with remote auditing and associated software applications

·     Experience with various Encoder, CAC and EHR software applications

·     Proficiency with MS Word, Excel and Power Point

Direct Reports – No  

Travel – No

Budget Oversight – No