Retrieves and audits medical records to determine if billing reflects the care documented, and identify areas of exposure and revenue enhancement based on CMS rules and regulations.Provide education based on findings.Position emphasis placed on auditing medical documentation and diagnosis and procedural coding, Medicare billing, teaching physicians regulations, and evaluation of management coding and training. Multi-specialty knowledge and experience preferred.MINIMUM QUALIFICATIONSTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.EDUCATION and/or EXPERIENCE Three to five years of coding experience. Must have CPC or CCS-P coding certification. Strong knowledge of MS Office Suite .(Excel, Word, Power Point) Strong computer skills. Strong interpersonal communication skills. Strong knowledge of CMS rules and regulations. Consideration will be given to those without CMS experience who have clinical certification.KNOWLEDGEKnowledge of clinic auditing policies and procedures.Knowledge of insurance.Knowledge of computer systems, programs, spreadsheets, data bases and applications.
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