Medical Auditor

Company: OUTCOME MATTERS, LLC
Location: Hackensack
Posted on: June 20, 2022

Job Description:

SUMMARY:This position is primarily responsible for billing, coding, and audit support for internal and external medical documentation reviews for the physician practice.ESSENTIAL DUTIES AND RESPONSIBILITIES:Core duties and responsibilities include the following.--- Gathering and reviewing medical documentation for compliance reviews.--- Reporting on same to allow for communication, education, and corrective action where appropriate.--- Supporting external reviews as well as organizing internal reviews to support routine auditing of practice records as part of the compliance program.--- Assist in further development of the routine, random auditing & monitoring program.--- Complete billing and coding for outpatient and inpatient physician services. This requires knowledge of CPT/ICD9/HCPCS coding practices as well as payer and federal regulations.--- Review all legal requests for physician group to ensure compliance with HIPAA, federal and state mandated guidelines for release. This will include working within time constraints of the requests.--- Perform other related duties as assigned by management.QUALIFICATIONS:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.EDUCATION AND/OR EXPERIENCE:--- Associate's degree (A. A.) or equivalent from two-year college or technical school; At least 3 years of billing and coding experience is required. AAPC Coding certification (CPC, CPC-P,CPC-D with maintained credentials is also required.LANGUAGE SKILLS:--- Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.MATHEMATICAL SKILLS:--- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.REASONING ABILITY:--- Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.COMPUTER SKILLS:--- To perform this job successfully, an individual should have knowledge of Accounting software; Database software; Inventory software; Order Processing systems; Internet software; Spreadsheet software and Word Processing software.PHYSICAL DEMANDS:--- The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.WORK ENVIRONMENT:--- The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.--- The noise level in the work environment is usually moderate.

Keywords: OUTCOME MATTERS, LLC, Hackensack , Medical Auditor, Accounting, Auditing , Hackensack, New Jersey