Physician Coding AuditorThe Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for Surgical, procedural and E/M based coding.Orlando Health is committed to providing benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions.
"Orlando Health Is Your Best Place to Work" is not just something we say, it's our promise to you.Orlando Health proudly embraces and honors the individuality of our team members. By sharing different ideas and perspectives and working together as a team, we are better able to relate to, care for and authentically serve our patients and families who make up the collective populations in our community. So, no matter who you are, what you believe or how you express yourself, you are welcome here.Orlando Health - Benefits & Perks:Competitive payEvening, nights, and weekend shift differentials offered for qualifying positionsAll inclusive benefits (start day one)Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility benefits, back up elder and childcare, pet insurance, PTO/holidays, and more for full time and part time employeesResponsibilities:Responsible for internal auditing and analyzing professional coding for all service linesReview medical records to ensure coding accuracyIdentify and communicate physician documentation and coding opportunities for improvementProvides feedback to physicians, non-physician providers, physician office staff, administration, practice managers, and team members of the Physician and Professional Services Central Business Office regarding best practices to ensure physician coding complianceCollaborates with Physician Coding Education Team to ensure appropriate and complete coding accuracy for payor guideline reimbursementUtilizes resource material available in department, CMS, AMA, AHCA and federal registry to support coding practicesMaintains patient and coder confidentiality audit resultsCollaborate with physician coding leadership for monitoring coding qualityParticipate in Health Plan AuditsFollow and adhere to Standards of Ethical Coding, all applicable regulations and guidelines, and all client specific policiesPerform physician queries for coding and documentation clarification during concurrent chart review processServes as a resource to new codersAddresses all Orlando Health departments professionally and positively, in all settings, by always maintaining a high level of professional demeanor and dressProficiency in coding including ICD-10, CPT, E/M, modifiers while maintaining a 90% accuracyAdhere to Standards of Ethical Coding, all applicable regulations and guidelines, and all client specific policiesMaintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state, and local standardsMaintains compliance with all Orlando Health policies and proceduresAttends payor, departmental and interdepartmental meetings as requiredWorks in collaboration for testing, training, and mentoring incoming coders according to the coding guidelines and individual skills for the Division for which the coder will be assignedConducts focused physician reviews as needed and provides data to managerQualifications:High School diploma or equivalentPossesses exceptional knowledge in Microsoft Office SuiteThorough knowledge of official coding guidelines as per AMA, AHCA, and CMS as evidenced by results of coding skills test of 90% or betterMust maintain one (1) of the following nationally recognized certifications:CPMA certification required through the American Academy of Professional CodersCoding Credential Required: AHIMA or AAPC credentialCEMA certification via National Alliance of Medical Auditing SpecialistsFive (5+) years of professional based coding experience in multiple specialties is required