• Job Description

  Req#: 558809

  Position Summary:

  The Coding Auditor audits patient records, ensures accuracy and compliance for healthcare professional claims. Maintain databases and audit patient charts and billing information for accurate processing of claims. Analyze, identify, and resolve billing issues that cause payment delays. Research and resolve patient, provider, and insurance company inquiries in a timely manner.

  Responsibilities:

  • Reviewing charts and identifying procedures: abstracting and auditing patients’ charts, utilizing ICD10, CPT and HCPCS codes classifications with accordance with the appropriate Medical Fee Schedule (for Work Comp cases refer to the state fee schedule that has jurisdiction).
  • Maintains communication with management and medical providers regarding significant issues or patterns observed regarding denials from insurance companies.
  • Communicate with Providers to ensure documentation is substantiating services perform, and it is accompanying with proper supporting documentation.
  • Ensure third party billing company compliance with Federal, Medicare, Commercial and State Worker’s Compensation regulations, including Official Medical Fee Schedules (OMFS) Medicare guidelines and state-specific rules such as NCCI.
  • Conduct regular audits to maintain high level accuracy and compliance of payors billing guidelines/regulations, including Medicare, Official Medical Fee Schedules (OMFS), Federal (DOL), and state-specific rules.
  • Review third party billing company’s coding and perform audits to determine accuracy and gaps.
  • Responsible for documenting audit errors for proper training.
  • Comply with all applicable HIPAA policies and procedures.
  • Verify completeness of open encounters and ensure chart documents are completed timely for submission.
  • Follow-up with Physicians to assure completing of all chart documents on a timely manner.
  • Collaborate with third party billing company to obtain and analyze additional information regarding billing process to be able to record and streamline effectively.
  • Assists with assigned projects that pertain to auditing under the direction of the RCM Billing Manager and Collection’s Supervisor.
  • Performs other job-related duties as assigned.

  Requirements:

  • Minimum of 5 years’ experience in coding/billing or in workers compensation bill review.
  • Must have knowledge of Federal and State Worker’s Compensation regulations, including Official Medical Fee Schedules (OMFS) Medicare guidelines and state-specific rules.
  • Expert knowledge of ICD-10 and CPT/HCPCS codes.
  • Knowledge of medical terminology/anatomy.
  • Knowledge of basic office equipment such as scanners, electronic faxing, iPad, copy machines, etc.
  • Excellent customer service skills.
  • Problem-solving skills.
  • Detail oriented and thorough.
  • Strong written and verbal communication skills .
  • Ability to collaborate with all levels within the organization.
  • Ability to deal professionally, courteously, and efficiently with internal and external customers.
  • Ability to work various shifts and overtime if needed.
  • Knowledge of all confidentiality requirements regarding patients and strict maintenance of proper confidentiality on all such information.
  • Knowledge of office ethics.
  • Time management skills and the ability to work independently to meet goals .

  
  

  Benefits:

  • Competitive salary
  • Comprehensive benefits package
  • Optimal work life balance with no nights, no weekends, and no holidays requirement to work
  • Opportunity to work in a fast-paced and dynamic environment
  • Be part of a team that is passionate about making a difference
  • Agile offers an annual CME Stipend ($1,000-$1,500) as well as Medbridge subscription

  Salary:

  Starting compensation range $31.25 hourly. Exact compensation may vary based on skills, experience, and location.

  Why You Should Join Our Team

  
  Agile Occupational Medicine is a leading occupational medicine group with a network of 24 clinics and one surgery center dedicated to providing comprehensive healthcare services to businesses and their employees across California and Yuma, Arizona. We specialize in ensuring the health and well-being of workers through a range of medical services, including injury care (workers’ compensation), physical examinations (employer services), and commercial (urgent care)

  We are a rapidly growing company with a fun and collaborative work environment. We are passionate about disrupting the world of occupational medicine, and we are committed to providing our customers and patients with the best possible experience. We offer our employees competitive salaries, commission, and benefits, and we give them the opportunity to make a real impact on the business.

  Agile Occupational Medicine is an Equal Opportunity Employer. Agile does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided upon qualifications, merit, and business need.

• About the company

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