Inpatient Auditor
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Inpatient Auditor

 

Job Type: Part-time, flexible hours (potential for full-time work in 2020)

Pay: Flexible DOE

Duration: One year with five option years (five year maximum)

Start Date: July 2019

Location: Laurel, MD

 

GENERAL SUMMARY

 

Under direct supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of Coding guidelines to provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements.

 

ESSENTIAL FUNCTIONS

  • Audits medical record documentation to identify under coded and up coded services; prepares reports of findings
  • Provides second-level review of billing performances to ensure compliance with legal and procedural policies and to ensure proper reimbursements while adhering to regulations prohibiting unbundling and other questionable practices
  • Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services
  • Obtains clarification of conflicting, ambiguous, or non-specific documentation.
  • Ensures strict confidentiality of records and Protected Health Information (PHI)
  • Attends training and in-house sessions to receive updated coding information and changes in coding and/or regulations
  • Performs miscellaneous job-related duties as assigned.

 

EDUCATION AND EXPERIENCE

  • Credentialed as CPC, CCS, CPMA or other AAPC, AHIMA certification
  • Minimum 1-year experience performing audits in professional or facility settings
  • Knowledge of auditing concepts and principles
  • Advanced knowledge of medical coding and billing systems and regulatory requirements.
  • Ability to use independent judgment and to manage and impart confidential information.
  • Ability to analyze and solve problems
  • Strong communication and interpersonal skills
  • Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation
  • Knowledge of current and developing issues and trends in medical coding procedures requirements.
  • Ability to clearly communicate medical information to professional practitioners and/or the general public

 

KEY COMPETENCIES

  • Reliable transportation
  • Organization and planning skills
  • Work management and prioritizing skills
  • Verbal and written communication skills
  • Attention to detail
  • Accuracy, flexibility, and reliability

 

 

Level One Personnel is an equal opportunity and affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other status protected by law.

 

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