Medical Records Auditor
Submitted on November 28, 2012 at 9:35 AM
Company: Kelly Services
Brief Company Description: LEFT BLANK
(615) 373 - 1302
Job Type: Full time
Hours: M-F, 8-5
Start Date: November 28, 2012
Compensation: LEFT BLANK
Education Level: Varies
RESPONSIBILITIES: Audit medical records for required documentation and clinical support; prepare reports of findings. Identify, label and organize medical records for the auditing and appeals process. Interact with patient care providers to obtain medical record documentation. Interact with government or commercial auditing entities to obtain decisions/clarifications about a claim. Research, analyze, and respond to audit inquiries, including but not limited to, claim review and medical record review. Enter audit and claim decisions into electronic management system accurately and proficiently. Interact with management to review audit findings. Ensure strict confidentiality of patient and financial records. Maintain coding certification through coding conferences and workshops to obtain updated coding information and relevant changes in regulations and/or coding requirements. Maintain strict confidentiality with regard to protected health information and understand and adhere to HIPAA Privacy & Security policies and procedures. Perform other duties as assigned. KNOWLEDGE, SKILLS and ABILITIES • Requires in depth knowledge of ICD-9 codes. • Requires in depth knowledge of Medicare/Medicaid guidelines. • Ability to effectively review findings/results with management. • Knowledge of medical record auditing concepts and principles. • Knowledge and understanding of medical coding and billing systems and regulatory requirements. • Strong communication and interpersonal skills. • Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation. • Ability to analyze and solve problems. • Detailed knowledge of medical coding systems, procedures, and documentation requirements. • Ability to use independent judgment and to manage and impart confidential information. • Ability to adapt, modify and prioritize audit functions as required.
MINIMUM QUALIFICATIONS Education and experience equivalent to: A minimum of four (4) years of health care work experience and a Coding Certification required (CPC, CPC-H, CCS, CCS-P). At least 2 years of experience auditing Evaluation and Management. Certified in Healthcare Compliance (CHC) a plus. Must have experience with all Microsoft Office programs, including, but not limited to; Word, Excel and Outlook.
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