Job Description

Overview

This position reports to the Director of Healthcare Compliance. Responsibilities include conducting billing and coding audits, and communicating results and recommendations to providers, management, and executive administration. This role will provide training and education to providers and ancillary staff. This position will support the implementation of changes to the CPT, HCPCS and ICD-10 codes on an annual basis.

Responsibilities

Essential Functions:

  • Conduct prospective and retrospective chart reviews (. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements.
  • Identify coding discrepancies and formulate suggestions for improvement.
  • Communicate audit results/findings to providers and/or ancillary staff and share improvement ideas.
  • Work with medical staff departme...

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