Medical Auditor – Project Lead

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Logo of AAPC

AAPC

51 - 200 employees

Founded 1988

⚕️ Healthcare Insurance

📚 Education

📋 Compliance

Healthcare Insurance • Education • Compliance

AAPC is the world's largest training and credentialing organization for the business of healthcare, with members worldwide working in medical coding, billing, auditing, compliance, clinical documentation improvement, revenue cycle management, and practice management. It provides a range of career training, continuing education, and networking opportunities for industry professionals to enhance their skills and advance their careers. AAPC offers courses to prepare for various respected coding certifications, thus supporting individuals in building successful careers in healthcare management and compliance.

📋 Description

• Oversee the management of multiple projects. • Manage client needs and expectations to ensure projects meet scope, requirements and deliverables are on-time and of high quality. • Perform production work in addition to project management, meeting department’s quality and production standard thresholds. • Responsible for maintaining department audit standards, clinical documentation standards, protocols and guidelines. • Review auditor work for accuracy and provide feedback written and verbally to auditors. • Audit medical records to validate clinical documentation to support evaluation and management services, ancillary services, procedures, and diagnoses and meet department quality and production standards. • Research regulatory guidelines for supporting documentation. • Prepare audit summary findings, providing detailed comments related to the audit findings and make recommendations. • Support team with department key performance indicators and goals (SLAs). • Embrace workforce transformation by engaging in continuous knowledge expansion across additional functional areas and/or upskilling (learning new skills) to support evolving organizational and client needs. • Contribute to organizational optimization by collaborating to identify opportunities for process improvement and supporting continuous enhancements to workflows and operations that promote quality and efficiency. • Prepares oral and/or written reports of client and audit activity for Manager, meeting with them on a regular basis to review individual performance, mentoring, and succession planning.

🎯 Requirements

• Extensive healthcare industry knowledge and experience in and around coding, billing, auditing, compliance and reimbursement for physician practices including CPT, HCPCS, & ICD-10 • Extensive coding experience in multiple specialties • Extensive knowledge of AMA, OIG, CMS and other national coding and compliance guidelines • Serve as a point of contact for clients, providing expert advice and recommendations on audit results. • Communicate effectively to ensure clients understand the complexities of their projects. • Experience developing and delivering training material, PowerPoint presentations, webinars and reports for physicians, management and coders • Demonstrated ability to successfully manage multiple projects simultaneously • Excellent written and verbal communication skills • Detail oriented and deadline driven attitude • Ability to think critically and determine the best method for completing tasks • Ability to multi-task and keep a sense of urgency • Strong organizational skills and work ethic • Proficient in Windows, Excel, Word, and PowerPoint • Certification Requirements: CPC® CPMA TM or RHIT

🏖️ Benefits

• medical, dental and vision insurance • 401(k) retirement plan • Health Savings Account (HSA) • generous PTO and holiday pay

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