COMPLIANCE CODING AUDITOR

Location
Norfolk, VA
Posted
Apr 06, 2017
Closes
Jul 24, 2017
Function
Audit and Tax
Industry
Healthcare
Hours
Full Time
Job Description:
Sentara Medical Group is currently recruiting for the position of Clinical Coding Auditor. This position is located at the Glenrock II building, Norfolk, VA. careerconnection

Performs a number of functions including those of physician education, internal auditing, coder
education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year. All queries arising from the audit process are managed by the Compliance Auditor. Follows audit plan, completing numerous audits and providing follow-up to coders, management, and physicians. Looks for new problem areas, trends, etc., and advises Manger of Audit and Coding Compliance. Works with leadership regarding scheduling of internal and external audits.

Education Level
Associate's Level Degree - Experience in lieu of education: Yes

Experience
Required: Acute Care - 4 years, Coding - 4 years

Preferred: None, unless noted in the “Other” section below

License
Required: Cert Coding Specialist, Cert Professional Coder

Preferred: Cert Medical Assistant, Licensed Practical Nurse, Registered Nurse

Skills
Required: Communication, Complex Problem Solving, Critical Thinking

Preferred: None, unless noted in the “Other” section below

Other
4 years Ambulatory/Acute Care experience and 4 years Primary Care/Specialty Professional Coding required. Should have high degree of comfort with technology; possess excellent oral and written communication skills, including basic teaching and presentation skill set; requires a high level of organizational skills, well-developed logical thinking and advanced problem solving skills.