Presenter/ Educator Coding Auditor - Remote
Company: Sonic Automotive
Location: Nederland
Posted on: May 6, 2022
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Job Description:
Overview Now hiring a Presenter/Educator Coding Auditor!! Chat
with us ! Reserve your spot today!! Summary With minimal
supervision directly supports the following responsibilities of the
Coding and documentation quality assurance (CDQA) team:
implementation of and compliance to enterprise-wide and department
coding policies and procedures for PHS; compliance to all external
regulatory agency coding rules and regulations; Demonstrates
high-level of proficiency in performing and/or managing on-site
internal audits or reviews to assess compliance/quality monitoring
performed by PHS/PMG departments while serving as a resource on
documentation, coding, billing, and coding compliance questions.
Works on special coding compliance related projects, develops and
presents educational programs, disseminates information to PHS/PMG
departments and develops educational tools used to maintain
compliance with regulations. Provides support via auditing and
training the enterprise-wide corrective action plans for coding,
audit, physician and clinician personnel identified as low
performers; perform medical record and billing reviews of denied
and appealed claims and takes appropriate action to ensure accurate
payment of claims; coordinate review and tracking of appealed
claims including the communication process with affected payers;
research and interpret all regulatory agency regulations Job
Description Type of Opportunity: Full Time FTE: 1.000000 Exempt:
Yes Work Schedule: Days/Remote This position is remote eligible to
candidates located in the United States with the exclusion of the
states: Washington, Ohio, Wyoming, and North Dakota.* Other
Information Qualifications High school diploma/GED required. Must
possess at least one of the following license/certifications: RHIT,
RHIA, CPC, CCS and a minimum of three (3) years experience in
coding and/or auditing required. Audit experience preferred.
Excellent written and verbal communication skills. . Excellent
written and verbal communication skills. Detail and results
oriented. Ability to work independently and make independent
decisions. Medical terminology, ICD-9, CPT-4 and HCPCS knowledge
required. Must have a proficient knowledge of Medicare, Medicaid,
and other third party payer documentation, coding, and billing
regulations for service lines(s) assigned. Must possess excellent
organizational and planning skills, including the ability to
prioritize multiple tasks and perform them both accurately and
simultaneously. Must possess computer skills, especially with
Microsoft Word, PowerPoint, and Excel applications. Must be able to
use the internet and other resource applications for research
purposes and to provide documentation that supports regulations
quoted in audits. Must possess strong written and verbal
communication skills in order to communicate in clear, concise
terms to management at all levels, including the ability to
articulate complex regulatory information in laymans terms. Must
possess a personal presence of a highly qualified professional that
is characterized by a sense of honesty, integrity, and the ability
to inspire and motivate others. Essential Education: High School
Diploma or GED Essential Credentials: Certified Professional Coder
Responsibilities Responsibilities Liaison to the Manager,
Information Services, Finance/Patient Financial Services, all
hospitals, all PMG sites, PHP, Home Health, Albuquerque Ambulance,
Compliance and all ancillary departments in addressing functional
coding, auditing, compliance and training issues and problems.
Interacts with all levels of management.esponsible for maintaining
accurate, complete and timely documentation in either electronic or
hard copy form Must be able to adapt to frequently changing work
priorities and schedules. Maintains and disseminates up-to-date
technical knowledge of legal and regulatory information from all
appropriate jurisdictions concerning the given business area. This
includes but is not limited to all ICD-9, ICD-10, CPT-4, HCPCS and
APC updates and changes Researches coding, billing and charging
compliance issues, recommends and implements corrective action
plans that assure compliance with regulatory agencies where
appropriate. Identifies risks, develops and follows up on action
plans, identifies lost revenue opportunities and any overpayments
due to errors in coding and/or documentation, and provides
compliance education Assists in the creation of the CDQA Annual
Audit Work-plan by utilizing the OIG work plan, Medicare and
Medicaid regulations, RAC and other audit agency focuses, as well
as internal and external risk assessments Regularly exercises
independent judgment in determining the reliability of data
reviewed; recommends changes in existing practices to gain or
maintain compliant behavior. Keeps actively informed on the
business climate of the healthcare industry Responds to inquiries
and requests daily regarding coding and auditing issues and
problems and ad-hoc analysis for all PHS management Maintains
up-to-date working knowledge of all PHS coding and auditing IT
applications Gathers and analyzes information and provides
recommendations to address and resolve business issues for a
specific business group Conducts training classes in areas of
coding, documentation and compliance for PHS/PMG personnel. This
includes preparation of training materials, educational audits and
answering specific situational questions, ICD-10 education and EPIC
EMR documentation education to providers and clinical staff
Conducts systematic focused internal audits via medical record and
charge ticket review to insure correct coding, billing and charging
as member of CDQA audit team Analyzes and summarizes data from
medical record and account audits and communicate results and
findings to management and complianceDevelops new methods and
processes to improve coding efficiency and effectiveness Researches
and investigates external and internal customer concerns regarding
patient care and/or billing of patient care. Ensures that coding
functions are performed in accordance with established quality and
performance standards by monitoring system generated reports and
quality audits Working hours may vary based on projects assigned
Must be able to travel to all of the PHS/PMG sites (including
overnight). Travel varies at certain times based on assignments
Benefits Benefits Benefits are effective day-one (for .45 FTE and
above) and include: Competitive salaries Full medical, dental and
vision insurance Flexible spending accounts (FSAs) Free wellness
programs Paid time off (PTO) Retirement plans, including matching
employer contributions Continuing education and career development
opportunities Life insurance and short/long term disability
programs About Us Presbyterian Healthcare Services is a locally
owned, not-for-profit healthcare system of nine hospitals, a
statewide health plan and a growing multi-specialty medical group.
Founded in New Mexico in 1908, it is the state's largest private
employer with approximately 11,000 employees. Presbyterian's story
is really the story of the remarkable people who have chosen to
work here. Starting with Reverend Cooper who began our journey in
1908, the hard work of thousands of physicians, employees, board
members, and other volunteers brought Presbyterian from a tiny
tuberculosis sanatorium to a statewide healthcare system, serving
more than 700,000 New Mexicans. We are part of New Mexico's history
- and committed to its future. That is why we will continue to work
just as hard and care just as deeply to serve New Mexico for years
to come. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free
employer with smoke free campuses. #NCS123by Jobble
Keywords: Sonic Automotive, Beaumont , Presenter/ Educator Coding Auditor - Remote, Accounting, Auditing , Nederland, Texas
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