Company Overview
Pride Health is a leading minority-owned healthcare recruitment & staffing firm that offers highly customized business process solutions at cost-effective prices. Headquartered in New York City as a top minority supplier, PRIDE Health offers a broad geographic reach with offices throughout the U.S., India, and Brazil. Leveraging more than 20 years of experience, PRIDE has enhanced its core competency of IT staffing services by creating client-centric, cost-effective IT, and business process solutions. PRIDE serves Client-Partners in the healthcare, IT, financial services, retail and insurance industries offering both Direct Hire and Temporary Staff of Healthcare Professionals, Vendor Management Systems, IT Hardware Procurement Services, and Business Processing Outsourcing. Temporary, Contract, Per Diem & Direct Hire staffing solutions are only part of what we can offer our clients. We work with our Client-Partners to customize workforce solutions and provide a value-add beyond traditional staffing. Exciting options such as: VMS: Manage order distribution, consolidate billing, and enhanced reporting capability that outperforms manual systems and processes. BPO: Increased flexibility in resource management and reduced response times to environmental changes; freeing our Client-Partners to focus on their core competencies.
About the job
Coding and Billing Auditor
Pride Health is seeking a Coding and Billing Auditor for one of its clients in Dover, Delaware.
This is for a direct hire position with competitive pay and benefits.
Location – Dover, Delaware (19901)
Pay range – $53K – $81K per year.
Length of assignment – Direct hire
Shift – Mon- Fri
Job Summary
Performs data quality reviews on provider records to validate the ICD-10 codes, CPT codes, and clinical documentation. Audits provider (physician and midlevel providers) records for accuracy of principal and secondary diagnosis and/or procedures and ensures compliance with all reporting and documentation requirements. Educates providers, coders, and charge entry personnel on coding guidelines and documentation requirements. Provides coding support to BHMG coding and billing staff.
Job Responsibilities
- Audits medical records for accurate CPT coding assignment. Compiles reports with an analysis of findings from the medical record audits. Ensures the selected CPT code supports the clinical documentation contained in the patient record. Consistently meets established productivity targets for record audits.
- Audits all establish provider medical records on by annual basis: Audits medical records for accurate CPT coding assignment.
- Maintains audit lodge for BHMG
- Compiles reports with an analysis of findings from the medical record audits.
- Ensures the selected CPT code supports the clinical documentation contained in patient records.
- Consistently meets established productivity targets for record audits.
- Medical Staff Relationship: Communicate (verbal/written) with providers to validate observations and suggest additional and/or more specific documentation
- Designs and implements, in collaboration with the Revenue Cycle Manager specific tools to support medical record physician documentation.
- Develops and implements plans in coordination with the Revenue Cycle Manager for both formal and informal education of providers.
- Communicates to participants the benefits of complete clinical documentation.
- Trains new employees on the BHMG revenue cycle team on coding and documentation guidelines
- Assistant Revenue Cycle manager with evaluation of coding activities and the performance evaluation of the revenue cycle personnel as needed
- Performs coding procedures as needed and warranted
- Develops and implements plans in coordination with the Revenue Cycle Manager for both formal and informal education of providers.
- All other duties as assigned within the scope and range of job responsibilities
Requirements
- Required Education, Credential(s), and Experience:Education: Associate degree-related field
- Credential: Certified Professional Coder
- Experience: Five (5) years of Inpatient /Outpatient coding and auditing experience
- Preferred Education, Credential(s) and Experience: Education bachelor’s degree-related field
- Credential: Certified Professional Coder
- Experience: Coding in multi-specialty group practice setting
How to Apply:
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