Remote: Medical Profee Audit & Education Specialist

This a Full Remote job, the offer is available from: United States

Remote: Medical Profee Audit & Education Specialist

IKS Health is seeking to hire a Profee Audit & Education Specialist

About IKS

www.ikshealth.com

Job Summary

Conducts clinical coding audits as defined by client contracts for audit service and internal quality assessment according to operational and client guidelines. The Audit staff will also contribute to the ongoing development and refinement of proprietary audit tools. The position will participate in mentor/trainer activities to internal coders, clients and providers as required by the deliverables of the contract and will be required to provide educational feedback and instruction in accordance to coding guidelines.

Essential Job Responsibilities

A Client-Related Duties –

Coordinate and oversee the auditor onboarding process for assigned clients.

Manage the performance of all quality for assigned clients.

Monitor and enforce IKSs compliance and quality program.

Ensure adherence to State and National Practice Standards for coding.

Serve as an official resource for coding-related questions from the coding staff & external clients

Provide project status reports to operational leadership, as requested.

Prepare Executive Reports and Presentations based off audit findings

Attend weekly client calls and client training sessions

B Auditing Team Duties –

Oversee the auditor on-boarding process

Work directly with the coding management team to ensure the educational needs coders and clients are met.

Provide coding and educational materials to clients

Assures internal coding audits are completed accurately and timely

Conducts coding audits adhering to nationally recognized coding guidelines and standards · Generates narrative audit summary reports as needed·

Perform auditing for a broad spectrum of cases.

Provide input and advice regarding educational topics based on audit trends

Represent company via professional meeting attendance and communication

Interact with audit peers, manager, coding staff, and operations team

Abides by the Standards of Ethical Coding as set forth by AHIMA

Maintains appropriate QA/QI and/or productivity logs or record entries ·

Education Specialist Duties

Create and maintain educational presentations & handouts for external and internal clients based off of trends and opportunities

Maintain Coding Knowledge and Serve as Coding Expert –

Attend internal and external meetings, as needed and requested, to provide input. and act as a coding information resource/expert.

Ensure IKS's compliance with all regulatory agencies.

Ensure IKS is HIPAA compliant at all times

Maintain all CEUs required for the position and attend educational seminars as needed.

Additional duties as assigned.

IKS Excellence -

Demonstrate a commitment to excellence in serving the client.

Demonstrate the IKS Health Core Values of Integrity, Quality, Team, Continuous Improvement, Expertise, and Innovation.

Job Qualifications

Education/Certification RHIT, RHIA, CPC, CPMA

Experience

Minimum 2 years of recent experience in auditing Profee claims.

Advanced knowledge of CPT, HCPCS, ICD-10 coding, and CMS billing policies for Profee services, E/M auditing

Knowledge and Skills

• Required Skills:

Independently performs highly complex and detailed coding reviews and audits to assess coding accuracy, documentation improvement opportunities, and mitigate risk.

Completes documentation audits and provides detailed and timely audit reports to providers and leaders.

Acts as subject matter expert in professional coding, including providing feedback and accurate guidance to physicians, advanced practice providers, professional billing staff, clinic staff, and clinic leaders.

Develops and presents customized education for professional coding, documentation guidelines, payer reimbursement rules, and regulations for physicians and advanced practice providers based on documentation audit findings.

Creates and effectively presents customized coding training for new physicians, advanced practice providers, and production coders.

Profee Auditor candidates must demonstrate advanced knowledge of APC-based reimbursement, medical necessity documentation requirements, guidelines for Observation services, and any relevant coding and documentation guidelines for specialty care areas. Working knowledge of how to research within the Medicare Claims and Processing Manuals is essential.

Working Conditions: Remote working environment; travel as required, extended periods of computer-based work.

Physical Demands: Prolonged computer screen usage, keyboarding. Long periods of sitting are commensurate with computer-based work and work-related phone calls. Normal Travel Requirements

Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.

Compensation and Benefits

The pay range for this position is $30hr- $33hr. Pay is based on several factors, including but not limited to current market conditions, location, education, work experience, certifications, etc. Aquity Solutions offers a competitive benefits package including healthcare, and paid time off (all benefits are subject to eligibility requirements for full-time employees). Aquity Solutions is an equal opportunity employer and does not discriminate based on race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status.

This offer from "IKS Health" has been enriched by Jobgether.com and got a 72% flex score.