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Lead Profee Auditor

2019-12-08 USD 100 1000000 Contract 2020-01-07
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5810 Coral Ridge Drive, Suite 250 Coral Springs FL 33076 USA
customer support [+954-656-8600]
  • Specialty:

  • 321 Main St.


    Maywood, IL 60153MaywoodIL
  • Start date:

    call for details
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Reports To: Audit Manager, Advisory

Overview: The lead auditor will have the primary responsibility of being an expert resource to the Sr Director, Audit Mgr of Advisory Solution.

Duties and Responsibilities

· Performs daily profee audits for Advisory clients.

· Audits medical record documentation to identify under-coded and up-coded services; Ensures compliance with performing an "Audit the Auditor" process. The lead auditor will perform audits on the auditors to ensure ongoing accuracy and compliance.

· Manages audit workflow between auditors and clients (data uploads, communication between auditors and clients, etc.).

· Provides research and assistance with answering coding questions from Auditors and clients as needed.

· Provides and creates education for clients.

· Interacts with physicians and other patient care providers regarding coding and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation.

· Trains, instructs, and/or provides support to auditors' onboarding of new clients.

· Touchpoint meeting calls with clients to discuss audit progress.

· Assists with projects, as needed.

· Performs miscellaneous job-related duties, as assigned.

Minimum Job Requirements

· Two year HIM degree and 3 years of direct auditing experience or technical certificate in Medical Coding with at least 10 years of coding experience and 5 years of direct auditing experience


· Expert knowledge of Medical Terminology, ICD-10/CPT-4 coding

· Educational development including internal and external presentations

· Good communication skills and ability to work with internal and external staff

· Intermediate knowledge of Microsoft Office – Outlook, Excel, Word and Power Point

Knowledge, Skills and Abilities Required

· Knowledge of auditing concepts and principles.

· Advanced knowledge of medical coding and billing systems and regulatory requirements.

· Ability to use independent judgment and to manage and impart confidential information.

· Ability to analyze and solve problems.

· Strong communication and interpersonal skills.

· Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation.

· Knowledge of current and developing issues and trends in medical coding procedures requirements.

· Ability to clearly communicate medical information to professional practitioners and/or the general public.

· Detailed knowledge of medical coding systems, procedures, and documentation requirements.

· Ability to adapt and modify medical billing procedures, protocol, and data management systems to meet specific operating requirements.

· Ability to provide guidance and training to professional and technical staff in area of expertise.

Working Conditions and Physical Effort

· No or very limited physical effort required.

· No or very limited exposure to physical risk.

· Work is normally performed in a typical interior/office work environment.

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Divisional Headquarters
Two Harbour Place
302 Knights Run Avenue
Suite 1025
Tampa, FL 33602
Phone: 813.418.3800
Toll Free: 1.866.727.4461
Fax: 813.418.2256