Physician Billing Auditor

Schedule: Monday - Friday 8:00am - 5:00pm, on site

Key Functions

1. Performs coding audits of the documentation and billing for professional services.
   1. Evaluates the quality of clinical documentation to identify incomplete or inconsistent documentation.
   2. Audits codes and professional fee services performed by providers from medical records according to ICD-10, CPT, HCPCS, and CMS guidelines and identifies areas of weakness.
   3. Responsible for maintaining up to date knowledge of coding guidelines as they relate to professional services.
   4. Develop and coordinate educational and training programs regarding elements of coding such as appropriate documentation, accurate coding, coding trends found during chart reviews, third party audit findings, and annual coding updates. 
   5. Follows up with providers as needed until documentation approves.
   6. Analyzes audit findings and generate reports to management. 

1. Maintains knowledge of information and functionality.
   1. Observes all HIPAA required practices including, but not limited to, maintaining HIPAA compliance and confidentiality for all patient and clinic information.
   2. Maintains knowledge of computer system functions as it pertains to Patient Accounts. 
   3. Enters patient demographics, insurance information, charges, and adjustments as needed. 

1. Provides administrative and training services 
   1. Serves as a resource to the providers and billing department.
   2. Assist clinicians with proper CPT coding selections.
   3. Orients and trains new providers throughout the year.
   4. Scan and index insurance correspondence.

1. Accepts additional assignments willingly.
2. Demonstrates an ability to respond to changing workloads.
3. Prepares in a timely and accurate manner all other tasks as assigned.
    
   

EDUCATION Required:   

High school diploma or equivalent

License/Certification

RHIA, RHIT, CCS, or CPC preferred    

Experience Required:  Two years of Revenue Cycle and hospital experience. Knowledge of Microsoft Office, including Word, Excel, and Outlook.