Documentation Auditor- Compliance- remote position Job at University of Maryland Faculty Physicians
University of Maryland Faculty Physicians Baltimore, MD 21201
Performs documentation audits of inpatient and outpatient records, provides analysis of the records reviewed, education and other assistance as needed. Audits include review of claims data and medical record documentation for professional fee (e.g., Medicare Part B) services. Verifies that billing reflects the care documented and that all applicable regulatory requirements were met. Identifies areas of potential exposure and/or revenue loss based on CMS regulations. Auditor must be proficient with CPT® procedural coding, ICD-10-CM diagnosis coding, Medicare teaching physician regulations and all other applicable CMS requirements. Multi-specialty knowledge and experience, including Evaluation and Management, is required. This position reports to the Compliance Program Manager, under the direction of the Chief Compliance Officer of FPI.; and other duties as assigned.
EDUCATION and/or EXPERIENCE
- Bachelor’s degree in healthcare related field is preferred
- 3-5 years of progressively responsible experience in multi-specialty physician/professional fee coding and documentation reviews
- Strong background in Evaluation and Management coding, including a thorough understanding of the 2020s CPT® guideline changes
- Two (2) years of physician/professional fee auditing experience and/or two (2) years of healthcare compliance experience is preferred
- Must have Certified Professional Coder (CPC) or Certified Coding Specialist-Physician Based (CCS-P) credential
- Must have Certified Professional Medical Auditor (CPMA) credential (or ability to obtain within 6 months)
- Experience in an academic medical center (AMC) is preferred
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