Auditor

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🐊 Florida, New Jersey, +7 more states – Remote

🐊 Florida – Remote 🏖️ New Jersey – Remote 🏈 Ohio – Remote 🦀 Maryland – Remote 🔔 Pennsylvania – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

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DIGESTIVE HEALTH

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2 - 10 employees

📋 Description

• Serve as a liaison between the practice and patients, and between the practice and outsourced RCM providers • Review professional fee billing, coding, and documentation • Audit physician billing practices against medical-record documentation for compliance with federal, state, and third-party requirements • Perform timely compliance and operational reviews based on the current OIG Workplan and compliance risk analyses • Identify compliance risks and revenue-capture opportunities • Determine corrections and refunds resulting from compliance audits and ensure completion • Analyze areas for documentation improvement • Prepare written reports • Provide education and training as needed • Conduct follow-up reviews when necessary • Communicate findings and recommendations for improvement • Stay current with governmental, state, and payer-specific documentation, coding, and billing rules • Answer coworker and staff questions regarding coding and compliance issues

🎯 Requirements

• Coding certifications (AAPC or AHIMA) and CPMA required • Strong knowledge of coding disciplines • Strong knowledge of medical terminology, medical billing, and payment methodologies • Knowledge of ICD-10, CPT, HCPC, and E/M coding guidelines • Comprehensive knowledge of procedure and diagnostic coding for professional services • Knowledge of Medicare, Medicaid, and other third-party payer coding and billing regulations • Knowledge of 1995 and 1997 Evaluation and Management Documentation guidelines • Knowledge of professional documentation requirements • Excellent verbal, written, and interpersonal communication skills • Strong computer skills, including Microsoft Office, Excel, and Word • Ability to multitask and meet multiple deadlines under pressure • Knowledge and understanding of HIPAA rules and regulations • Must reside in Pennsylvania, Maryland, New Jersey, Delaware, Texas, Tennessee, West Virginia, Indiana, Georgia, Florida, or Ohio • Must be authorized to work in the US for any employer • Occasionally stand, walk, sit, and reach with hands and arms • Occasionally lift or move up to 25 pounds

🏖️ Benefits

• Fully remote work • Full-time, 8-hour shift, Monday–Friday schedule • Equal Opportunity Employer