Employer Industry: Healthcare Services

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on physician billing compliance
- Engaging work that involves problem-solving and training
- Competitive benefits package including health insurance and retirement plans

What to Expect (Job Responsibilities):
- Conduct physician coding/documentation audits for compliance with various coding standards and guidelines
- Analyze audit findings and summarize results for the Physician Billing Compliance Services central database
- Participate in audit conferences with representatives from the employer
- Identify training needs and conduct remedial training for providers and billing staff
- Assist in developing policies and procedures to align with the employer’s Billing Compliance Plan

What is Required (Qualifications):
- Minimum of 2 years of medical billing experience
- Minimum of 4 years of medical coding (procedural and diagnosis) for multi-specialty providers
- Minimum of 3 years of experience with Medicare, Medicaid, and Tricare payment and reimbursement rules
- Minimum of 3 years of medical record chart auditing for professional billing
- High School Diploma or GED required; certification as a Certified Coding Specialist is required or must be attained at the time of hire

How to Stand Out (Preferred Qualifications):
- 1 year of experience using medical management information systems (EPIC preferred)
- 1 year of experience with auditing software applications (e.g., MDaudit, Compliance Risk Analyzer)
- Associates degree in business or healthcare-related field preferred
- Certification as a Certified Professional Medical Auditor (CPMA) preferred within 6 months of hire

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