Medical Billing Auditor - (Not Remote)
Company: Ohio ENT & Allergy Physicians
Posted on: January 16, 2022
Summary of Duties: To develop and maintain a QA program to ensure
compliance and accuracy with billing and coding guidelines and
Supervision & Reporting: Reports to Billing Director
--- 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
--- 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
--- Track results and provide scorecards to staff members and
--- 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
Education: High School Diploma
--- 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
--- Qualified applicant should have at least 3 years' experience in
--- Excellent oral and written communication skills required.
--- Knowledge of AthenaHealth (formerly GE-Centricity) practice
management software and EHR packages beneficial but not
--- Knowledge of Microsoft Office software required.
--- Ability to create spreadsheets and tables in Microsoft
--- 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.
Keywords: Ohio ENT & Allergy Physicians, Columbus , Medical Billing Auditor - (Not Remote), Accounting, Auditing , Columbus, Ohio
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