Regulations Auditor at Addison Group
Posted in General Business 12 days ago.
This job brought to you by eQuest
Location: Columbia, Maryland
ESSENTIAL DUTIES AND RESPONSIBILITIES (include but not limited to):
- Conduct Coder QA and Education as part of identified remediation
- Collaborate with Management on development of individual or group performance improvement plans related to billing compliance or coding issues
- Develop or review internal workflow or pathway directives that impact coding and charge capture
- Conduct coder Pre- production QA and education
- Documentation review and Feedback sessions
- Documentation template improvements
- Coding and Regulatory Updates related to Specialty coding and procedures
Training & Curriculum:
- Development and delivery of coding educational materials and training for use both internal and external to the department, including physicians live and remote methods.
- Maintain operational workflow pathways and assist coding leads as needed
- Maintain Coding resources shared library
Other Job Responsibilities:
- Utilizes knowledge of revenue cycle, analyzes coding data to assist with QA selection process
- Assist in supporting teams with analysis and review of documentation for new business
- Maintains confidentiality of sensitive information concerning patients, physicians, employees, clients, vendors, and the company.
- Ensure compliance with all State, Federal, professional regulations as well as department rules, policies, and procedural manuals.
- Adherence to Safety Regulations.
- Adherence to HIPAA Regulations.
- Maintain specialty certification CEU’s, coding updates and all regulatory or payer guidance
- Other duties as assigned.
REPORTING TO THIS POSITION: No direct reports
JOB REQUIREMENTS (Knowledge, Skills and Abilities):
- Communicate well with the public
- Ability to read, write, and speak English
- The individual in this role must possess a National coding certification (AHIMA, AAPC) and have compliance auditing and Specialty Coding Education experience
- National Certification and Minimum of five years’ Experience in physician coding, Anesthesia/Pain Management, Surgery and E/M, ICD-10, with experience in Academic settings.
- Proficient in MS Office including Excel, Word and Power Point
- Experience in Revenue Cycle and Claim processing
- Demonstrated superior presentation skills
- Experience managing multiple simultaneous clients or projects with a high level of attention to detail
- This position covers Maryland and Florida, travel is required
- Requires prolonged sitting, some bending, stooping and stretching
- Must possess sufficient eye-hand coordination/manual dexterity to operate a keyboard, photocopier, telephone, calculator and other office equipment
- Required normal range of hearing and eyesight to record, prepare, and communicate appropriate reports and evaluations.
- Requires lifting papers and boxes weighing up to 35 pounds occasionally
- Requires dexterity to type at least 35 wpm.
WORKING CONDITIONS (environment and safety):
- Work performed in office environment
- Involves frequent contact with professional staff and managed care organizations
- Work may be stressful at times
- Interaction with others is frequent and often disruptive