Physician Practice E&M Auditor Educator, MCVI Administration

Overview

Baptist Health is the region’s largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence.

For 25 years, we’ve been named one of Fortune’s 100 Best Companies to Work For, and in the  U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 45 high-performing honors.

What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families that extend beyond delivering care. Many of us have walked in our patients’ shoes ourselves and that shared experience fuels our commitment to compassion and quality. Our culture is rooted in purpose, and every team member plays a part in making a positive impact – because when it comes to caring for people, we’re all in.

The ideal candidate will have CIRCC Certification as well and experience in interventional coding. E&M Coding Auditor/Educator performs comprehensive audits to determine integrity of coding/billing for physician & clinical fees, detection/correction of documentation, coding/billing errors and/or medical necessity of services billed. Audits consist of evaluation of the accuracy of documentation, including E/M and other payer codes, medical necessity, reimbursement over payments and underpayments, and compliance with other documentation standards.

Researches and applies all federal guidelines & compliance with the overall audit delivery. Develops and executes provider comprehensive educational opportunities/curriculums (coding resources, materials, tools, webinars, campaigns, etc.) based on audit results, noted trends & changes within coding compliance and regulatory guidelines, while supporting organizational compliance models. Leads provider‘s education events to discuss overall audit results overview, identifying trends and action plans.

Provides support or project management for any other related audit and coding initiatives and assist in other related responsibilities as required by executive leadership team. Establishes positive working relationships as the subject matter expert with all parties to provide input on risk and ensure a sustained understanding of federal coding compliance requirements. Estimated pay range for this position is $26.13 - $33.97 / hour depending on experience.

Degrees:

• High School, Cert, GED, Trn, Exper.

Licenses &

Certifications:

• AHIMA Certified Coding Specialist-Physician-based.
• AAPC Certified Professional Coder.
• AAPC Certified Professional Medical Auditor.

Additional Qualifications

• Prior Physician Coding & Auditing, Revenue Cycle or billing related to Coding.
• Upon Hire, CPC-Certified Professional Coder and/or CCS-P-Certified Coding Specialist-Physician required.
• CPMA-Certified Professional Medical Auditor upon hire or must be completed within 1 year.
• Overall experience to include at least 2 years of professional E&M coding experience and 2 years of E&M provider education experience.
• Strong knowledge of E&M regulations and CMS Documentation Guidelines.
• Successful experience with data abstraction and analyze patient encounters for a focused review sample and development of comprehensive coding education materials and resources.
• Proficient in ICD
  10CM
  , CPT and HCPCS coding, policy and procedures based on physician practices.
• Strong organizational skills and attention to detail.
• Ability to prioritize provider medical record reviews/projects and provider coding education opportunities with alignment with audits and overall trends.
• Work independently with little or no supervision.
• Ability to provide excellent customer service.
• Excellent computer skills and proficient in Microsoft Office and generating reports.

Minimum

Required Experience:

4 Years

EOE, including disability/vets