Facility ED Auditor
We are currently recruiting for remote credentialed Facility Auditors proficient in ED with at least 3-5 years’ experience in addition to any formal training. If you are a successful Facility Auditing Professional that will bring a wealth of experience to our team, apply today to take advantage of our flexible remote career opportunities.
The Facility ED Auditor is responsible for assigned auditing projects and assisting clients in maintaining compliant auditing operations. These projects include, but are not limited to auditing, instruction/education, reimbursement theory, clinical documentation opportunities/improvements, as well as use and interpretation of data analytics.
Researching and reviewing all applicable coverage determinations/policies in order to evaluate medical necessity and resulting appropriate reimbursement; follow all reporting rules (e.g., application of modifiers, reporting POA) and correct coding rules. Coordinates and provides education content, financial impact information and other statistical reports, as well as conducting an education session and exit conference for client after audit is completed. Insures that appropriate person (e.g., compliance officer, attorney, etc.) is apprised of all potential compliance risk areas if/as they are identified.
High quality skills with E/M facility leveling using ACEP guidelines
Provides, if required, continuing education to internal and external clients regarding changes to coding and reimbursement systems.
Assumes personal responsibility for professional growth, development and continuing education in order to maintain a high level of proficiency.
Maintains confidentiality of all types of protected health information and personally identifiable information.
Mentors team members in areas to promote team work and elevate skill sets.
Other duties as assigned
Certified as CCS as well as CDIP or CCDS required
Must have 3-5 years experience with E/M facility leveling using ACEP guidelines
Must have 3 years ED CPT experience WITH injections and infusions.
Direct experience with and knowledge of hospital revenue cycle, auditing, coding validation, and/or physician/practitioner E/M theory and revenue cycle.
Experience with presentation of education and/or audit results to high level hospital representatives. Ability to communicate effectively with physicians and other clinical disciplines.
Thorough knowledge of medical terminology, anatomy and physiology and pathophysiology.
ICD-10 Implementation, training of others in ICD-10 and/or native I-10 experience
Remote work experience preferred
Advanced Microsoft office user and Power Point
Good communication skills both written and verbal required
Must use own computer with Professional Windows 10, dual monitors and reliable high speed internet