Auditing & Education Consultant – Professional Fee

Role Overview

• Serves in a consulting role by evaluating the work of client’s coders in their assignment of ICD-10, CPT and/or HCPCS codes to hospital inpatient, outpatient and/or physician practice encounters.
• Performs concurrent or retrospective reviews to inventory code assignments and report the data to the client.
• Develops and delivers educational content to clients related to audit findings.
• Validate coded data as recognized by the AHA, CMS, AMA, AHIMA, AAPC, Coding Clinic, and CPT Assistant within the professional fee billing model.
• Analyze findings and identify potential root causes of produced errors.
• Prepare summary reports of findings to clients, supplying specific references supporting findings contained within the provided audit report.
• Provides second-level review of processes to ensure compliance with legal and procedural policies and to ensure appropriate code assignments.
• Research, analyze, and respond to inquiries regarding compliance, coding, and denials.
• Functions as a member of the Consulting Services Team which develop and provide coding education to clients.
• Conduct Audits as assigned meeting the productivity standards as set by record type for each audit.
• Prepare deliverables for the client as required for the audit scope while meeting timelines.
• Conduct independent QA of their assigned audit results prior to final submission for QA review and approval.
• Report work time and work products in a timely and accurate manner.
• Communicates with coworkers in an open and respectful manner that promotes teamwork and knowledge sharing.
• Interact with clients in a professional manner that exhibits excellent relationships, work performance and communication skills to support the company and its business interests.
• Provide schedule of planned work activities, events and sites, and any changes to same, to Management and appropriate staff.
• Maintenance of professional credentials and knowledge of coding, reimbursement, and compliance issues through continuing education.

Requirements

• 5+ years of auditing in professional fee (profee)
• E/M leveling Coding certification through AHIMA or AAPC required (CPC, COC, CIC, CCS, RHIT, RHIA)
• Experience with telecommuting and electronic medical record systems required.
• Strong analytical skills.
• Proficient computer skills, specifically Microsoft Office products.
• Strong team player.
• Ability to work with multiple and diverse clients and projects.
• Ability to work with minimal supervision.
• Ability to maintain and access multiple files.
• Assure that work product is completed with high levels of accuracy and attention to detail.

Benefits

• We build long-term careers by investing in YOU.
• Must have 5+ years of auditing in professional fee (profee) with E/M leveling Coding certification through AHIMA or AAPC required (CPC, COC, CIC, CCS, RHIT, RHIA)
• Experience with telecommuting and electronic medical record systems required.
• Strong analytical skills.
• Proficient computer skills, specifically Microsoft Office products.
• Strong team player.
• Ability to work with multiple and diverse clients and projects.
• Ability to work with minimal supervision.
• Ability to maintain and access multiple files.
• Assure that work product is completed with high levels of accuracy and attention to detail.