Outpatient Auditor
- Must have a Coding certification from AHIMA or AAPC
- 3+ years Outpatient professional fee coding experience
- ICD-10-CM, CPT coding & Evaluation and Management experience
Review Outpatient medical records and clinical documentation to provide documentation improvement feedback to providers, along with validation of accurate code assignment from the medical records in accordance with Official Coding Guidelines. A clear understanding of physician, mid-level provider, and resident’s documentation guidelines, within a teaching facility, is required.
Review patient encounters for accurate professional fee code assignment of all relevant ICD-10CM diagnosis, CPTs procedures, including Evaluation and Management leveling, and modifier assignment. The ability to provide detailed feedback audit feedback and provide associated supporting references. Perform coder and/or Provider education regarding audit findings.
- Perform daily professional fee quality audits to ensure accurate code assignment based on the Provider documentation in accordance with State & Federal regulations, in compliance with current industry standards supported by documentation in the medical record.
- Provide detailed feedback on any documentation trends per provider.
- Provider education on documentation trends to ensure accuracy of the medical record, accurate coding.
- Answer provider and/or coder questions.
- Communication directly with site coding management.
- Perform education sessions for providers and/or coder, based on audit findings.
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