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Facility Outpatient Auditor – ED, SDS, OBS, I&I
CorroHealth. Perform complex retrospective analysis of medical record documentation to identify coding and billing errors and inconsistencies .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical coding and auditing, ensuring compliance with coding guidelines and optimal reimbursement. Proficient in analyzing coding errors, providing training, and maintaining high coder accuracy and productivity.
Highest-signal resume keywords
CPC CertificationInpatient/Outpatient Coding ExperienceStrong Analytical SkillsMicrosoft Office ProficiencyTelecommuting Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical CodingAuditingCompliance AnalysisCoding Guidelines InterpretationBilling Code ReviewQuality AssuranceRoot Cause AnalysisDocumentation AssessmentPatient Health Information ProtectionCoder Productivity Improvement
Soft Skills
Strong Verbal CommunicationStrong Written CommunicationAttention to DetailInitiativeTeam Player
Tools & Technologies
Electronic Medical Record SystemsMicrosoft WordMicrosoft Excel
Certifications & Qualifications
CPCCCSRHIARHIT
Industry Keywords
Coding ErrorsBilling ProcessesHospital Outpatient BillingAPC AssignmentHealthcare Compliance
About the role
Key responsibilities & impact- Perform complex retrospective analysis of medical record documentation to identify coding and billing errors and inconsistencies
- Analyze audit findings to identify root causes of coding errors and prevent recurrence
- Conduct second-level reviews of diagnosis, procedure, and billing codes for compliance and optimal reimbursement
- Research and respond to inquiries regarding compliance, inappropriate coding, denials, and billable services
- Provide technical support, feedback, and training to internal coding staff
- Protect patient health and client information confidentiality
- Suggest physician query opportunities and query physicians based on documentation and clinical needs
- Prepare deliverables for coders
- Report work time and production accurately and promptly
- Provide work schedules and changes to management and appropriate staff
- Maintain professional coding credentials and knowledge through education
- Monitor coder progress and success
- Maintain coder accuracy at a minimum of 95% and QA review percentages near 10%
- Identify and resolve coding quality problems
- Assist with systems designed to improve coder productivity and coding accuracy
- Provide monthly and status reports
- Participate in corporate training and meetings
- Interpret coding guidelines and assess documentation's impact on code assignment and reimbursement
- Comply with internal policies, privacy and security rules, ethical coding standards, and the Company’s Code of Ethics and Business Conduct
Requirements
What you’ll need- Must live in the United States
- Must have a recognized coding credential from AHIMA or AAPC; RHIA or RHIT may also be considered
- CPC, COC, CCS, RHIT, or RHIA credentials referenced; CPC or CCS preferred
- Experience with ED, SDS, OBS, and I&I
- Facility inpatient/outpatient auditing and coding experience
- Minimum 2 years of experience coding and/or auditing for inpatient and outpatient facilities; preferably 3 years
- Minimum 1 year of customer service support experience
- Familiarity with hospital outpatient billing processes
- Understanding of hospital APC assignment and associated coding and documentation
- Experience with telecommuting and electronic medical record systems strongly preferred
- Strong analytical skills
- Strong verbal and written communication skills
- Proficiency in Microsoft Office applications, including Word and Excel
- Ability to navigate a variety of EMR environments and review handwritten charts
- Ability to prioritize workload, meet deadlines, and maintain quality and accuracy
- Ability to work with multiple and diverse clients and projects
- Ability to work with minimal supervision
- Regular, predictable, and punctual attendance
- Initiative, resourcefulness, and attention to detail
- Strong team-player skills
Benefits
Comp & perks- Professional development and personal growth opportunities
- Company-provided training and education
- Reasonable accommodations for individuals with disabilities
- Remote work arrangement