Medical Billing Auditor Job in Memphis 38104, Tennessee US
Working within the Compliance group, implements systematic data-based documentation and coding audits in multiple settings and specialties.
Reviews academic physician surgical, procedural, diagnostic and visit documentation to ensure compliance with Federal and State laws, Medicare Teaching Physician regulations and UTMG compliance standards.
Identifies compliance issues and risks.
Communicates recommendations for corrective action.
Completes audit work papers and audit report.
Integrates activities with coding, denials/appeals and work process team to eliminate errors and deficiencies.
Provides relevant education and consultation to physicians, coders and clinical personnel.
KEY RESULT AREAS (KRA's) ¨ Implement audit work plan¨ Medical record documentation reviews¨ Audit completion and reporting¨ Information confidentiality and security ¨ Development of learning resources ¨ Coding education delivery¨ Effective provider relationships ¨ Audit operational processes¨ Denials analysis¨ Data-base managementKNOWLEDGE, SKILLS & ABILITIES, EDUCATION and/or EXPERIENCE¨ 3-5 years min ICD-9-CM & CPT code structure & documentation including unique requirements for Teaching Physician & E/M service billing & use of CPT code modifiers.
¨ Extensive physician professional service coding & documentation audit knowledge & exp in hospital based in-patient & surgical professional services & ambulatory clinic & office based professional services.
¨ Knowledge National Correct Coding Initiatives & Local/National Medical Review Policies ¨ Academic multi-specialty physician auditing and billing experience preferred¨ Experience in specialty physician coding from medical record documentation¨ Advanced IDX, Excel/Access data extraction abilities preferred¨ BS in Business, Accounting or Health Information Administration, preferred¨ CCS-P, RHIT, CPC, or CPC-H certification required ¨ Excellent analytical, organizational and interpersonal skills ¨ Effective communication skills¨ Proficient in Word, Excel, and Powerpoint¨ Ability to research and interpret complex regulatory guidance
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