Location: Remote
Schedule: FT Hourly Employee
Benefits:
- Medical, Dental, Vision Insurance
- 401(K) with Employer Match
- Life Insurance
- FSA Plans
- Employee Assistance Program (EAP)
- CEU?s and Continuing Education
- And more!
Job Summary
eCatalyst Healthcare Solutions? (?eCatalyst?) is actively hiring Professional Fee (PB) Auditors to join our diverse and dynamic team of Health Information professionals.
As a Professional Fee Auditor, you will perform auditing for one of our valued client partners.
Duties/Responsibilities:
- Provide client services and lead, coordinate, and perform all functions of quality reviews for PB coding across multiple clients in multiple specialty groups and settings.
- The PB Auditor performs quality reviews on coders ensuring compliance with coding guidelines and company policies for complete, accurate, and consistent coding.
- The Professional Fee Auditor will assign and sequence ICD-10, CPT/HCPCS Level II codes, including E/M leveling, and all appropriate modifiers through review of documentation and diagnostic results as appropriate for billing, internal and external reporting, research, and regulatory compliance.
- Knowledge expert and maintains up-to-date working knowledge of coding guidelines in order to act as a resource and point person for issues and question for coders, customers, or project teams.
- Provides education to audit clients or internal eCatalyst coders as required by the deliverables of the contract.
- Reviews physician documentation for coding appropriateness and accuracy following AMA and other national and state approved coding and billing guidelines.
- Knowledge of billing/edit practices preferred.
- Reviews and analyzes medical records for accurate code selection.
- Provides feedback to coders and providers on coding corrections, appropriately citing authoritative resources.
- Assists with the interpretation of codes and other information requested for accurate code assignment.
- Communicate with management regarding clinical, coding, and reimbursement issues as needed.
- Function in a professional, efficient, and positive manner with strong critical thinking and decision-making skills.
- Utilizes our client?s electronic medical record (EMR), encoder, and computer-assisted coding (CAC) software as directed.
- Ensures optimal reimbursement while maintaining compliance with CMS and third-party payor policies and guidelines.
- Maintains compliance with eCatalyst and client?s coding policies, procedures, and guidelines.
- Consistently maintains 95% or above accuracy rate while meeting established productivity standards.
- Completes daily production log and daily time keeping requirements.
- Attends and participates in eCatalyst and client meetings as requested.
- Completes coding continuing education and maintains auditing credentials.
- Ensures HIPAA compliance at all times.
- Consistently delivers eCatalyst?s brand promise of ?Exceptional Services Delivered with Unrelenting Client Focus? to our client partners.
Source: Indeed.com
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