OP Auditor

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Job Details

OP Auditor

Job Overview

OP Auditor

Overview:

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Client is looking for a OP Auditor!

Remote

Duties/Responsibilities:

  • Provide client services and lead, coordinate, and perform all functions of quality reviews for outpatient coding across multiple clients. 
  • Performs quality reviews on coders ensuring compliance with coding guidelines and company policies for complete, accurate, and consistent coding.
  • Reviews include Outpatient ICD-10, CPT, APC, CPT Modifiers, ED E&M and professional coding and E&M assignments.   
  • 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 coding guidelines.
  • Facility OP auditing including Same Day Surgery, Observation, ED, and Ancillary visit types. Profee multi-specialty experience is a plus.
  • 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 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 client meetings as requested.
  • Completes coding continuing education and maintains auditing credentials. 
  • Ensures HIPAA compliance at all times.

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