Certified Professional Healthcare Coder (Remote)

Empower Healthcare and Compliance is looking to add to our audit/coding team a Certified Professional Coder (CPC) Manager. 

 Work From Home Opportunity for Certified Professional Healthcare Coder

This job is responsible for the successful delivery of detailed and complex medical record reviews for Client Audits. The incumbent is responsible for interfacing with clients and staff. The incumbent is responsible for completion of coding audit reviews of medical records and coding for appropriate interpretation and designations including chart documentation review, ICD10 and CPT coding audit, and creating detail oriented, appropriate findings report for the client. Ensures compliance with required Regulatory Audit guidelines are being met with regards to coding and documentation.

ESSENTIAL RESPONSIBILITIES

• Ensures completion of projects to meet departmental deadlines.
• Communicates and collaborates with management and coding/audit team(s) to ensure deliverables are met or exceeded.
• Conducts coding and documentation reviews: review documentation and coding for all services (including but not limited to; E & M level of service, Surgical procedures, modifier usage, diagnosis code supporting medical necessity, labs and radiologic examinations).
• Ensures audit compliance with AMA/CMS Coding Guidelines and Payer Coding Guidelines.
• Reviews and analyzes weekly reports to ensure appropriate quality review performance and results.
• Conduct data analyses from medical record reviews to identify opportunities to improve provider documentation, coding and revenue.
• Interfaces with client programs for provider education to identify educational opportunities for targeted providers.
• Identifies and collaborates in developing process improvement initiatives.
• Performs research on various compliance/coding topics, including for example new and existing regulations, best practices and assess implications for the client.
• Researches and provides feedback related to provider regulatory inquiries.
• Develops training materials and monitoring tools for provider education based on audit finding and regulatory guidance.
• Prepares final audit reports per exact specifications for client audit or coding.
• Other duties as assigned or requested.

 EDUCATION

Required

• Associate’s degree in healthcare, Clinical or Business Related

EXPERIENCE

• 5 years’ experience with clinical documentation auditing
• 5 years’ experience with facility coding and/or Outpatient/ASC experience
• Experience applying and referencing supporting resources, such as CPT and ICD-10 Official Guidelines, CPT Assistant, LCDs and NCDs, Local Carrier Guidelines and Payer Policies, to support audit findings and recommendations
• Knowledge of current guidelines and regulations for physician coding & billing and experience applying and referencing supporting resources, such as CPT and ICD-10 Official Guidelines, CPT Assistant, LCDs and NCDs, Local Carrier Guidelines and Payer Policies, in support of audit findings and recommendations
• Excellent written and oral communication skills
• Proficiency in creating PowerPoint decks to reflect audit findings, opportunities and areas of focus and incorporating redacted medical record documentation to illustrate documentation principles
• Ability to create a comprehensive report of audit findings
• Experience with moderate Excel functionality (e.g. pivot tables, basic formulas)
• Multiple EMR experience required
• Dental coding/auditing experience preferred
• Orthopedic coding/auding experience preferred

Preferred

• 5 years of Coding Project Management

To Include:

• 3 years of monitoring, evaluating audit progress, reporting and work prioritization within cross functional teams

CERTIFICATIONS

Required

• Certified Coding Specialist (CCS), or
• Certified Professional Coder (CPC) 

REQUIREMENTS

Availability during the work week and weekends as needed