Medical Billing Auditor - (Not Remote)

Company: Ohio ENT & Allergy Physicians
Location: Columbus
Posted on: January 16, 2022

Job Description:

Description:
Summary of Duties: To develop and maintain a QA program to ensure compliance and accuracy with billing and coding guidelines and requirements

Supervision & Reporting: Reports to Billing Director

Essential Functions:

--- Develop audit program to ensure staff is following all assigned processes, protocols and compliance guidelines
--- Develop physician audit program and provide routine physician education related to audit findings and coding changes
--- Review charges entered by billing staff to ensure compliance & accuracy with coding and billing requirements
--- Review charts to ensure appropriate documentation is present for all charges
--- Review claims payments to ensure accuracy of all components, including write off and balance transfers according to payer fee schedule & EOB
--- Review accounts worked by AR staff for appropriate account follow-up and resolution
--- Perform routine audits of office and hospital visits to ensure the documentation properly supports the E&M levels billed
--- Review all documentation requests by payers for pre-payment or medical necessity audit prior to submitting requested documentation
--- Develop and maintain a training program with the assistance and support of Billing Manager and Director
--- Modify/revise corporate billing policies as a result of audit findings, with the support and assistance of the Billing Director
--- Track results and provide scorecards to staff members and billing manager
--- Identify areas that could be improved and/or staff that would benefit from additional training
--- Conduct face-to-face meetings with providers to review audit results and provide additional education as needed
--- Assist with the on-boarding of new billers and on-going education of existing coders to maintain coding accuracy
--- Maintain current knowledge of coding and documentation guidelines

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Requirements:
Education: High School Diploma

Skills/Experience:
--- Qualified applicant must be AAPC certified
--- Qualified applicant must have thorough knowledge of 1995 and 2021 E&M Guidelines
--- Qualified applicant should have good knowledge of medical terminology
--- Qualified applicant should have at least 3 years' experience in medical billing
--- Excellent oral and written communication skills required.
--- Knowledge of AthenaHealth (formerly GE-Centricity) practice management software and EHR packages beneficial but not required.
--- Knowledge of Microsoft Office software required.
--- Ability to create spreadsheets and tables in Microsoft Excel
--- Ability to operate a computer and basic office equipment.
--- Ability to establish and maintain effective working relationships with Physicians and all co-workers.
--- Must be well organized and detail-oriented.

Environmental/Working Conditions: Medical office environment.

Work hours: 8:00 a.m. - 5:00 p.m. Occasional overtime and travel may be required.

Physical Demands: Requires sitting and standing associated with a normal office environment. Manual dexterity needed for using computer keyboard. Responsibilities, skills and working conditions may change as needs arise.

PI158430791

Keywords: Ohio ENT & Allergy Physicians, Columbus , Medical Billing Auditor - (Not Remote), Accounting, Auditing , Columbus, Ohio