Toledo Clinic

  • Toledo, OH, United States
Toledo Clinic Toledo, OH, USA
Job Description Job Description General Summary: Responsible for reviewing, analyzing, disseminating, and reporting data on chart audits as well as audit documentation requirements of services billed per pre-established criteria approved by the Director of Compliance. Responsible for the processing of Medicare and other insurance carrier audit requests, such as Performant Audits, Targeted Probe Reviews, Overpayment Recoupment Efforts. Assist Internal Auditors as needed. Assist Medical Offices for coding and claims as needed. Works under the Supervision of the Quality and Compliance Director Principal Duties & Responsibilities: Example of Essential Duties: Audit medical records for data collection and format, coding documentation and content utilizing pre-established criteria. Meets with physicians to review audit results and makes needed recommendations. Audit medical record for adherence to Toledo Clinic Electronic Medical Record policies and procedures,...

Toledo Clinic Toledo, OH, USA
Job Description Job Description General Summary: Responsible for reviewing, analyzing, disseminating and reporting data on chart audits as well as audit documentation requirements of services billed per pre-established criteria approved by the Director of Compliance and the Quality and Compliance Committee. Works under the Supervision of the Quality and Compliance Director Principal Duties & Responsibilities: Example of Essential Duties: Audit medical records for data collection and format, coding documentation and content utilizing pre-established criteria. Meets with physicians to review audit results and makes needed recommendations. Audit medical record for adherence to Toledo Clinic Electronic Medical Record policies and procedures, documentation of quality measures, treatment plans, patient follow-up, as well as federal and insurance guidelines. Performs educational sessions with physicians as needed. Creates educational programs for physicians and coding staff to...