Title/Position: Audit Specialist CPC/CPMA
Department or Business Unit: HIM & Coding Integrity
Reporting Structure: Manager, Audit and Education
Employment Type: FTE
Exemption Status: Exempt
Min. Experience: Mid-Level
Travel Required: No
Overview of the role:
Under indirect supervision, the Audit Specialist audits medical charts and records for compliance with federal coding regulations and guidelines. Successful candidates will have experience with procedural auditing.
Primary Job Duties:
- Audits medical record documentation to identify undercoded and upcoded services; prepares reports of findings and meets with providers to provide education and training on accurate coding practices and compliance issues.
- Interacts with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation.
- Trains, instructs, and/or provides technical support to medical providers and Medical Coding Analysts as appropriate regarding coding compliance documentation, and regulatory provisions, and third party payer requirements.
- Interacts with providers and management to review and/or implement codes and to update charge documents.
- Ensures strict confidentiality of financial records.
- Performs all focused projects as assigned.
- Performs miscellaneous job-related duties as assigned.
- 5 years’ working experience required
- Certified Professional Coder (CPC) required and Certified Professional Medical Auditor (CPMA) or willingness to obtain certification within 6 months of obtaining position required
- Proficient ability to use a computer and electronic medical record.
- Must comply with all HIPAA rules and regulations.
Work is performed in an office environment. Employees must have the ability to lift, move and store supplies and other material weighing up to 10 lbs. Specific vision requirements include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.