[Hiring] Physician Practice E&M Auditor Educator @Baptist Health South Florida

Role Description

The E&M Coding Auditor/Educator performs comprehensive audits to determine the integrity of coding/billing for physician & clinical fees, detection/correction of documentation, coding/billing errors and/or medical necessity of services billed. Responsibilities include:

• Evaluating the accuracy of documentation, including E/M and other payer codes, medical necessity, reimbursement overpayments and underpayments, and compliance with documentation standards.
• Researching and applying all federal guidelines & compliance with the overall audit delivery.
• Developing and executing comprehensive educational opportunities/curriculums (coding resources, materials, tools, webinars, campaigns, etc.) based on audit results, noted trends & changes within coding compliance and regulatory guidelines.
• Leading provider education events to discuss overall audit results overview, identifying trends and action plans.
• Providing support or project management for related audit and coding initiatives and assisting in other responsibilities as required by the executive leadership team.
• Establishing positive working relationships as the subject matter expert with all parties to provide input on risk and ensure a sustained understanding of federal coding compliance requirements.

Estimated pay range for this position is $26.65 - $34.65 / hour depending on experience.

Qualifications

• Degrees: High School, Cert, GED, Trn, Exper.
• Licenses & Certifications:
  • AAPC Certified Professional Medical Auditor.
  • AHIMA Certified Coding Specialist-Physician-based.
  • AAPC Certified Professional Coder.
• Additional Qualifications:
  • Prior Physician Coding & Auditing, Revenue Cycle or billing related to Coding.
  • Upon Hire, CPC-Certified Professional Coder and/or CCS-P-Certified Coding Specialist-Physician required.
  • CPMA-Certified Professional Medical Auditor upon hire or must be completed within 1 year.
  • Overall experience to include at least 2 years of professional E&M coding experience and 2 years of E&M provider education experience.
  • Strong knowledge of E&M regulations and CMS Documentation Guidelines.
  • Successful experience with data abstraction and analysis of patient encounters for focused review samples and development of comprehensive coding education materials and resources.
  • Proficient in ICD10CM, CPT and HCPCS coding, policy and procedures based on physician practices.
  • Strong organizational skills and attention to detail.
  • Ability to prioritize provider medical record reviews/projects and provider coding education opportunities with alignment with audits and overall trends.
  • Work independently with little or no supervision.
  • Ability to provide excellent customer service.
  • Excellent computer skills and proficient in Microsoft Office and generating reports.

Requirements

• Minimum Required Experience: 4 Years

Benefits

• Career growth and development opportunities, with clear pathways and ongoing support.
• Comprehensive health and wellness resources that go beyond traditional benefits.
• A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs.
• Tuition reimbursement to support continued learning and advancement.
• And so much more.