Coding Compliance Auditor & Educator - Full Time - Quincy Medical Group
Quincy, IL 62301
About the Job
At Quincy Medical Group, we work to understand what matters most to our employees, and we invest in helping them flourish both personally and professionally. We provide a comprehensive benefits package that includes paid leave options, childcare assistance, tuition reimbursement, and paid volunteer and community impact opportunities. This role is Monday - Friday, 8:00am-5:00pm.
The role involves assisting in the development and organizational review of compliance policies and procedures and implementing the Compliance Plan to ensure correct and appropriate coding and billing. This includes identifying specific risk areas and strategies to promote compliance, detection, and correction of potential risk exposures, and reporting these findings to the appropriate leader as necessary.
They will provide annual monitoring and auditing activities on a sample size of medical record documentation of all medical providers to monitor compliance with coding and billing rules and regulations. Results will be delivered directly to the involved medical provider or Physician Liaison and the Compliance Officer, with extended reviews occurring for providers falling outside of the established compliance norms for accuracy. Additionally, the role involves assisting medical providers and employees with direction on the usage of specific diagnosis codes, CPT codes, modifiers, or documentation requirements, processing all compliance-related billing, and assisting in audit policy development, implementation, and follow-up processes.
A Professional Coder Certification (CPC) with the American Academy of Professional Coders (AAPC) is required within three years of employment in the department. Preferred qualifications include three to five years of auditing and/or coding experience, previous clinical experience (e.g., RN, LPN), and knowledge of Medicare and Medicaid. Effective interpersonal skills are necessary to interface with physicians and initiate corrective action as needed.
Discover Your Future at Quincy Medical Group
By submitting an application, I attest that I meet the qualifications and am able to perform the essential functions of this position with or without reasonable accommodation.
