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Professional Fee Clinical Documentation Specialist

Overview

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We are looking for a strong Medical Coding Auditor for a unique role that combines audit of both outpatient/professional fee services as well as CMS risk adjustment capture. This role requires the ability to flow between both professional fee outpatient coding guidelines as well as understanding the methodologies involved with risk adjustment. The Auditor will review work completed by coders and provide education based on audit findings to ensure best coding practices are used to maintain accuracy to specified targets.  The ideal individual will possess the ability to switch across multiple project types and be able to implement unique guidelines quickly.
This position reports to the Managed Services Department and is fully remote.

Responsibilities:

  • Audit ICD-10-CM risk adjustment code capture as applicable.
  • Audit E&M codes for outpatient E&M services as applicable.
  • Provide routine feedback of coder work to ensure quality standards are maintained.
  • Provide education to improve upon best practices and quality enhancement where needed.

Requirements:

  • Minimum 3 years’ experience in auditing professional fee services.
  • Minimum 2 years’ experience in risk adjustment coding/auditing methodologies.
  • CPC, CCS, CRC preferred. CPC-A, is not eligible at this time.
  • CPC with additional CPMA and/or CRC preferred.
  • Ability to shift between guidelines per project needs.
  • Experience with Excel, EMRs, and Encoders.
  • Computer skills proficiency – MS Windows, MS Office (including Excel), Teams, Internet, etc.
  • High Speed Internet access.

Skills Needed:

  • Extensive knowledge of ICD-10-CM risk adjustment methodologies and outpatient guidelines.
  • Reliability and determination to meet standards as expected.
  • Discipline and dedication to succeed while working remotely with minimal oversight.

 
Location: remote,
Type: Contract To Hire
Pay: Apply for details

1543

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