Medical Coding Auditor & Physician Trainer

· Project Management experience preferred.
· CPC-I Or CPMA Certification

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· High School diploma or equivalent required.
· Minimum 10 years in the billing/coding/medical records experience.
· 5 years of recent certificated Coding and Auditing experience
· Proficient in E/M, Infusion, Oncology, and/or Surgery coding specialties.
· Active CPC Certification
· Computer proficiency with Microsoft Office Suite, including MS Word, Excel, Access, PowerPoint, and EMR systems

This position provides physicians and business office staff with applicable billing/ coding and related reimbursement guidelines, including federal/state laws and regulatory requirements affecting daily business operations. This information is researched and delivered through regular network publications, and electronic and voice communications. Participates in developing and maintaining reimbursement education materials, reviews data reports for coding compliance, and provides and/or coordinates the necessary education through meeting presentations.

The essential duties and responsibilities (including but not limited to)
· Provide coding and billing education as a subject matter expert in specialty-specific categories.
· Researches, prepares, develops, and delivers subject matter material to present to network practice physicians, clinical team, and business staff via web-based, and other methods of training.
· Educate and provide guidance related to ICD-10-CM, ICD-9-CM, CPT, HCPCS coding systems.
· Provide guidance related to government regulations and commercial payer policies.
· Educate and provide coding and billing guidance on all new or revised coding for drugs, technologies, and procedures.
· Prepare material through research of payer guidelines for claims denials and assist other departments with claims appeal responses.
· Ongoing review of medical record documentation, for coding and documentation compliance.
· Upon request, support network practices with a review of medical record documentation, including but not limited to evaluation and management, medical and radiation oncology, genetic counseling, clinical research, surgical, and other specialties.
· Provide feedback and education on documentation, coding, and billing.
· Provide support and guidance for new In Market Affiliation (IMA) chart reviews.
· Assist payer audit team with responses to payer audits including but not limited to RAC, CERT, ZPIC, SMRC, and commercial payers.
· Participates in the development and implementation of network practice chart audit programs.
· Collaboration with other MSH departments to provide coding and billing guidance and support.
· Project management duties include scheduling and coordination with multiple levels of leadership, physicians, clinical and business staff, the RSS department, and other MSH teams.
· Review, research, and respond to practice billing and coding questions.
· Conduct, participate and provide support in practice and committee calls.
· Lead designated subject matter expert (SME) initiatives.
· Collaborate, coordinate, and participate in other projects and duties as needed or requested.

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.