"Alerted.org

SUMMARY:

Performs random provider documentation audits and provides feedback and education to providers regarding correct coding and documentation requirements. Resolves complex coding scenarios. Works with AR to resolve coding related denials. Serves as liaison between the practice and Physician Network Services and/or other departments

SOME SPECIFIC DUTIES MAY INCLUDE:

+ Conduct pre-submission review of a minimum of five claims per provider on an annual basis

+ Conduct pre-submission review of a minimum of five claims and meet with all new AnMed providers within 60 days of start date

+ Discuss audit results and issues with physicians, non-physician practitioners, operation managers and office managers

+ Conduct special audits as determined by monthly utilization reports

+ Perform education to physicians, non-physician practitioners, office management and/or staff on special audit results

+ Reviews and codes complex operative procedures for all service lines

+ QUALIFICATIONS

Required:

+ High school diploma or GED required

+ Certified professional coder (CPC) certification required

+ Minimum of 2 years CPT, HCPCS and ICD-10-CM coding experience required

Preferred:

+ Use of typing, computer and other office skills in everyday job performance, one to two years previous experience in computer billing, filing, typing, etc.

+ Reimbursement of third-party carriers and other insurance knowledge

+ Additional 3 years coding Auditing experience