Certified Medical Coding Auditor (CPC or CCS-P)
21 days ago
Bakersfield
Job DescriptionDescription: About Us Simply put, our purpose at Accelerated Urgent Care is to get you quality care when you need it. We aim to foster a supportive environment where our team members can develop their careers. To promote this goal, we’ve built a diverse and driven team of employees who are all eager to learn from one another and reach Accelerated Urgent Care’s mission of delivering exceptional healthcare to the patients and communities that we are privileged to serve. We are ... a fast-growing company that doubles in size year after year since 2012! Recognized as Kern County’s Top Urgent Care center 6 years in a row! Dedicated to our employees’ career growth; 65% of our Administration and Management team members have been internal candidates! 16 clinics strong across 5 regions in California and growing! Our Core Values: Friendliness, Competence, Respect, Teamwork, Compassion, Hard work, Integrity, Humility, Dedication! Job Summary The Certified Medical Coding Auditor will provide formal and informal coding and regulatory education to all providers and billing staff as directed by American Medical Association (AMA), Centers for Medicare & Medicaid Services (CMS), and various payer requirements. The individual in this position will also conduct internal audits to ensure anyone involved in the billing for professional services is in compliance with regulations, along with payer policies and procedures. Essential Functions (not all inclusive) • Perform detailed coder audits on a regular basis as defined by compliance requirements, determine if additional education is necessary and notify Leadership of ongoing education needs., • Work closely with the Medical Directors to create, revise, and update all educational tools, modules, and materials as it relates to the coding and regulatory guidelines under the direction of Leadership., • Conduct internal audits of medical documentation supporting claims billed to third parties to ensure billing is performed in accordance with the appropriate third-party regulations and/or standards:, • Evaluate the appopriateness of the services and procedures billed based on the supporting documentation., • Evaluate the appropriateness of diagnoses billed for all services in accordance with coding guidelines., • valuate the appropriateness of E&M level of service billed based on the supporting documentation, in accordance with current AMA standards.Conduct educational documentation and coding training for providers to support compliance with third party documentation and billing standards., • Create tracking tools to capture and document audit results on an ongoing basis, for reporting and historical lookback purposes., • Prepare formalized reports of audit results and present findings to Leadership and Medical Directors, potentially providers., • Respond to questions from providers and the billing team regarding billing, coding, and documentation., • Develop educational programs for providers based on audit findings along with general education on coding and documentation rules and regulations., • Perform follow up reviews after initial training of providers to determine if additional education is necessary., • Provide any additional training once identified by follow-up review., • Communicate regularly with internal departments to ensure all necessary information is received on a timely basis., • Communicate and problem solve with Medical Directors and Leadership on specific coding issues and/or training requests., • Perform any and all other assigned responsibilities., • Perform special projects and other duties as requested., • Comply with departmental policies and procedures., • Perform all duties and tasks with the highest level of professionalism, which includes professional communication and professional attire., • Responsible for showing up to work on time and being available to all team members during work hours, Monday through Friday, 8am to 5pm., • Work well with all AUC providers, staff members, Leadership., • Provide personal commitment and ownership to enhance knowledge, skills, and abilities in healthcare related financial areas., • Maintain patient confidentiality and information security, adhere to all HIPAA regulations and requirements., • Demonstrated knowledge of Medical Terminology and Anatomy & Physiology combined with high level expertise in third-party payer reimbursement, coding, and documentation requirements., • Knowledge of Medicare and Medicaid regulations., • Knowledge of current AMA guidelines., • Experience in a teaching/academic medical environment is a plus., • Excellent and effective communication and listening skills, oral and written – clear, concise, articulate, empathetic, and friendly – to support work with a wide range of different people and groups, including large audience presentations., • Ability to train and teach adults., • High level proficiency in the use of various computer systems including Microsoft Word, Excel, PowerPoint, Outlook, and other database tracking systems., • Exceptional customer service skills, email/telephone/virtual meeting etiquette, and display positive personality attributes., • Strong time management skills, including use of technology and software to facilitate prompt task execution., • Highly detail oriented, thorough, and responsible., • Excellent tracking and organizational skills., • Ability to multi-task, adapt to a variety of responsibilities that may change on a daily basis, focus and execute relevant goals., • Excellent problem solving and critical thinking skills., • Display a positive, focused, and solution-oriented attitude., • Ability to work independently on assigned tasks, in addition accepting direction on given assignments., • Demonstrate a high level of performance, accountability, integrity, professionalism, openness, and receptiveness to change., • Ability to perform in the best interest of business needs., • Ability to meet deadlines and prioritize workload and tasks on an ongoing basis., • Involves sitting down for prolonged periods of time., • Must be able to have face-to-face conversations with vendors, employees, and the Leadership Team., • Ability to communicate verbally with an excellent comprehension of the English language., • Must be able to lift 25 lbs. Position Type: Full-time Position Hours: Monday - Friday, 8 am - 5 pm Job Type: Hourly, Non-Exempt Benefits: Medical, Dental, Vision, Life Insurance and PTO. Requirements: Required Education and Experience • Must possess an active CPC or CCS-P certification in conjunction with auditing credentials (i.e. CPMA)., • 3+ years of medical auditing and coding experience working with providers, preferably in an urgent care or healthcare setting., • High school diploma or equivalent., • Bachelor’s degree in Healthcare Administration (or related field) (preferred)
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