Physician Practice E&M Auditor, Educator

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🔥 10 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $26 - $33 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

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Baptist Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🤝 Non-profit

Healthcare • Non-profit

Baptist Health is the region's largest not-for-profit healthcare organization in South Florida. It operates 12 hospitals, more than 29,000 employees, 4,500 physicians, and roughly 200 outpatient centers, urgent care facilities, and physician practices across Miami-Dade, Monroe, Broward, and Palm Beach counties. The system includes renowned centers of excellence in cancer, heart and vascular, brain and spine, and orthopedic care, and is supported by philanthropy and a faith-based mission. Baptist Health emphasizes clinical quality, patient safety, staff development, and community-oriented care.

📋 Description

• E&M Coding Auditor/Educator performs comprehensive audits to determine integrity of coding/billing for physician & clinical fees, detection/correction of documentation, coding/billing errors and/or medical necessity of services billed. • Audits consist of evaluation of the accuracy of documentation, including E/M and other payer codes, medical necessity, reimbursement overpayments and underpayments, and compliance with other documentation standards. • Researches and applies all federal guidelines & compliance with the overall audit delivery. • Develops and executes provider comprehensive educational opportunities/curriculums (coding resources, materials, tools, webinars, campaigns, etc.) based on audit results, noted trends & changes within coding compliance and regulatory guidelines, while supporting organizational compliance models. • Leads provider’s education events to discuss overall audit results overview, identifying trends and action plans. • Provides support or project management for any other related audit and coding initiatives and assist in other related responsibilities as required by executive leadership team. • Establishes positive working relationships as the subject matter expert with all parties to provide input on risk and ensure a sustained understanding of federal coding compliance requirements.

🎯 Requirements

• CIRCC (Certified Interventional Radiology Cardiovascular Coder) certification by the AAPC • Experience coding interventional procedures (Cardiac Cath, EP-Electrophysiology, IVR-Interventional Radiology, IVN-Interventional Neuro) • High School, Cert, GED, Trn, Exper. • AHIMA Certified Coding Specialist-Physician-based. • AAPC Certified Professional Coder. • AAPC Certified Professional Medical Auditor. • CIRCC Certification preferred. • Prior Physician Coding & Auditing, Revenue Cycle or billing related to Coding. • Upon Hire, CPC-Certified Professional Coder and/or CCS-P-Certified Coding Specialist-Physician required. • CPMA-Certified Professional Medical Auditor upon hire or must be completed within 1 year. • Overall experience to include at least 2 years of professional E&M coding experience and 2 years of E&M provider education experience. • Strong knowledge of E&M regulations and CMS Documentation Guidelines. • Successful experience with data abstraction and analyze patient encounters for a focused review sample and development of comprehensive coding education materials and resources. • Proficient in ICD10CM, CPT and HCPCS coding, policy and procedures based on physician practices. • Strong organizational skills and attention to detail. • Ability to prioritize provider medical record reviews/projects and provider coding education opportunities with alignment with audits and overall trends. • Work independently with little or no supervision. • Ability to provide excellent customer service. • Excellent computer skills and proficient in Microsoft Office and generating reports.

🏖️ Benefits

• Career growth and development opportunities, with clear pathways and ongoing support • Comprehensive health and wellness resources that go beyond traditional benefits • A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs • Tuition reimbursement to support continued learning and advancement • And so much more