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Regional Coding Auditor & Educator in Clyde, NC at Harris Regional Hospital

Date Posted: 2/16/2019

Job Snapshot

Job Description

Harris Regional Hospital

The Regional Coding Auditor and Educator performs E&M and CPT coding audits as well as other projects related to physician coding compliance.   Educates physicians and clinic staff on proper clinical coding and documentation standards and rules.  Demonstrates a thorough understanding of complex coding, reimbursement, and auditing principles as they relate to physician practices and clinic settings. Keeps informed regarding current coding regulations, professional standards and company/department policies and procedures and effectively applies this knowledge. Monitors external audits for compliance and enters notices into ARTHUR MD.
General Responsibilities:

1. Completes coding training with new start up physicians and staff.
2. Conducts pre-bill audits on first 20 claims for new startups.
3. Conducts monthly 10 chart audits per provider when scores are less than 90% while submitting one of the monthly audits to appropriate Compliance Manager to fulfill self-audit requirement for those who score 70-79% on their Ethics & Compliance Coding Audit.
4. Conduct focused pre-bill audits for providers who score lower than 70% on their audits from Ethics & Compliance.
5. Educate coders/billers of code changes.
6. Monitor compliance of policies including CEU requirements.
7. Assist with completion and monitoring of action plans issued from Ethics and Compliance.

Job Requirements

Minimum Qualifications: (Experience, Education and Special Certifications)

* One or more of the following certifications (or eligibility therefor):
  o CPC 
  o CEMC – Within 18 months of Start Date
  o CPMA – Within 18 months of Start Date
* At least two years of physician coding experience or equivalent.

This job description in no way states or implies that the key accountabilities above are the only ones being performed by the individual(s) with this job description. The individual(s) may be called upon and required to follow or perform other duties and tasks requested by his or her supervisor, consistent with the purpose of the position, department and/or company objectives.

Physical Requirements: 

Long periods of sitting may be required.  Repetitive motion of wrists required.  Lifting requirements are minimal to none. Corrected vision and hearing to normal range is required.

Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran