POSITION PURPOSE
MINIMUM EDUCATION REQUIRED
MINIMUM EXPERIENCE REQUIRED
LICENSES / CERTIFICATIONS REQUIRED
KNOWLEDGE, SKILLS & ABILITIES REQUIRED
Knowledge of CPT and ICD-10 codes
Ability to accurately audit provider documentation to ensure all CPT codes and ICD-10 codes are accurately assigned
Ability to communicate findings by way of written reports and via verbal communication with provider(s) and management staff
Proficient computer and typing skills and familiarity with Microsoft programs such as Word and Excel
Ability to understand and interpret policies and regulations
Ability to read and interpret clinical documentation
Ability to write, hear, and speak the English language
PRINCIPLE ACCOUNTABILITIES AND ESSENTIAL DUTIES
Responsible for conducting internal monitoring and auditing of provider documentation.
Responsible for communicating audit findings to the provider(s), and/or appropriate management staff by way of written or verbal reports.
Responsible for monitoring provider’s compliance with the auditing program and reporting noncompliance to the appropriate individual.
Responsible for reviewing all insurance guidelines to ensure coding/documentation compliance.
Responsible for acting as a resource for Physicians’ Billing and Clinic staff with issues related to documentation and/or compliance.
Responsible for interacting with physicians to clarify diagnoses or procedures.
Responsible for seeking out resources, including appropriate management staff, for questions or other issues. #cb
Froedtert South is a comprehensive regional healthcare system that has served southeastern Wisconsin and northern Illinois communities for more than 100 years. Froedtert South provides services primarily through the Froedtert Kenosha Hospital and the Froedtert Pleasant Prairie Hospital and several other clinic locations.
Froedtert South is an Equal Opportunity Employer. Froedtert South does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment decisions are made on the basis of qualifications, merit, and business need.
