Physician Compliance Auditor 2

Temp to Perm:Temp w/ possible

Length of Assignment:90 days

Work Location:Fully Remote

Work Schedule:Mon-Fri 8a-5p

Pay Range: $26/hr - $42/hr

Interview Type:2 rounds of interviews

Certification/Degree Requirements:CPC, CCS, RHIT - must have one and Please attach in resume

Top Skills:Provider education/audit required, 5 years exp minimum, epic is preferred



Restricted States: California, Hawaii, New Jersey, New York, North Dakota, Oregon, Puerto Rico, Rhode Island, US Virigin Islands, Washington, Wyoming



Last Updated: May 13, 2019JOB



SUMMARY:Currently, there is only one level of Physician Compliance Auditor. Even though there are some more advanced and knowledgeable Physician Compliance Auditors, they all have the same designation. A great dissatisfier repeatedly in the People Survey has been the lack of opportunities for advancement in Compliance. Risk Management and Revenue Cycle Management both have several levels of coders/auditors. This would help to give Physician Compliance Auditors an additional position to aspire to. Information highlighted in red highlights the differences between Physician Compliance Auditors I and II.



WHAT IS EXPECTED (Essential Functions):

1. Perform annual chart audits (mostly in their areas of expertise) and formulate recommendations based upon the audit findings and communicate them to the appropriate personnel.

2. Implement annual coding reviews and ensure that compliance issues and areas of risk are identified and addressed.

3. Develop curriculum to be used in orienting and educating providers and staff in the specialty clinics to medical record documentation guidelines and standards and to diagnostic and procedural coding conventions and methodologies.

4. Assist in specialty coding educational sessions with Revenue Cycle Management (RCM) and Risk Based Coding.

5. Coding compliance resource and consultant for all physicians and advance practice providers, company administrators and physician practice staff.

6. Prepare and submit compliance reports to the compliance committee.

7. Serve as a coding and documentation resource to Physician Coding Auditors I and RCM on specialty (cardiology, neurology, orthopedics, etc.) coding.

8. Cross-train other Physician Coding Auditors in their area(s) of expertise in order to provide more depth and flexibility to the department.

9. Maintain working knowledge of Federal, State, private payer, and other applicable legal and regulatory requirements for the compliance department.

10. Special projects as needed.

11. Performs other position appropriate duties as required in a competent, professional and courteous manner.



KNOWLEDGE, SKILLS AND ABILITIES:

1. Knowledge of CPT, ICD-10 and HCPCS. (Link to 1,2,3,7,8 above)

2. Ability to research topics regarding compliance and coding efficiently and accurately. (Link to 2,3,4 above)

3. Able to clearly and concisely explain compliance concerns and resolutions with the ability to comfortably discuss the same with all members of the organization. (Link to 1,2,3,8 above)

4. Proficient in Word, Excel, and PowerPoint (Link to 4,5,6 above)

5. Four years auditing experience.



The information contained in this job description is intended to describe the essential job functions required of those assigned to this job. It is not intended to be an exhaustive list of all responsibilities, duties, knowledge, skills, and abilities needed to perform the job. Please note that management retains the right to assign or reassign duties and responsibilities to this job at any time. The ability to competently perform all the essential duties of the position, with or without reasonable accommodation, demonstrated commitment to effective customer service delivery, integrity, and the ability to work productively as a member of a team or work group are basic requirements of all positions at ***.