STAR Medical Auditing Services

ProFee/Facility Auditor (Remote)

Are you a skilled and credentialed medical coding and auditing professional looking for an amazing team to join? Look no further! STAR Medical Auditing Services is hiring.

ProFee/Facility Auditor (Remote)

JOB DESCRIPTION

As a ProFee & Facility Auditor you will be assisting STAR with medical auditing for our clients. Must have strong auditing skills with experience in multiple specialties and settings, including behavioral health. We will train on client specifics however you are expected to have a thorough understanding of general auditing principles and procedures including outpatient coding guidelines. Experience with multiple EMR’s is preferred. Must have strong attention to detail with 97% or higher quality maintained. Coding assessments are required to be considered for this position. This is a contract position that is fully remote with a flexible schedule. Must work a minimum of 20 hours per week. Must be US-based.

RESPONSIBILITIES

  • Reviews medical records to identify diagnoses, CPT procedures and modifiers relative to the patient’s encounter.

  • Abstracts appropriate information from the medical record based on the guidelines provided by the client and after a thorough review of the medical record.

  • Solicits clarification from the physician regarding ambiguous or conflicting documentation in the medical record using guidelines provided by the client.

  • Ensure all coding complies with the ethical coding standards/guidelines and regulatory requirements.

  • Maintains strictest confidentiality; adheres to all Health Insurance Portability and Accountability Act guidelines/regulations

  • Completion of audits for multiple clients and projects requiring following specific client policies and procedures

EXPERIENCE/QUALIFICATIONS

  • Must have one of the following AHIMA/AAPC certifications: CPC, CCS, RHIA, RHIT

  • Extensive knowledge of medical terminology, anatomy and coding guidelines for ICD-10, CPT, HCPCS and E/M codes

  • At least 2 years of recent active auditing experience in ProFee & Facility Coding including but not limited to:

    • ProFee E/M for ED, New and Established office Visit, Inpatient and Observation

    • Facility E/M for ED and Clinic

    • Facility Observation Hours

    • ProFee CPT for Behavioral Health

    • ProFee E/M for Nursing Facility Visits preferred but not required

    • Minor Procedures done in office or ED

    • Infusions, injections, vaccinations & immunizations (adult & peds)

    • Modifier usage

    • NCCI Edits

  • Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures, and documentation including CMS guidelines

  • Maintains strictest confidentiality; adheres to all Health Insurance Portability and Accountability Act guidelines/regulations

  • Proficient computer skills using MS-Word, Excel, Outlook and Internet Explorer, electronic medical records (EMR) systems including Epic, Cerner, Meditech, EMA, Athena, etc. along with computer assisted coding programs.

  • Meet required client productivity standards and maintain minimum of 95% accuracy

  • Self-sufficient with strong analytical and research skills

  • Responsible and responsive

  • Strong attention to details

  • Excellent written and oral communication skills

  • Ability to meet deadlines

  • Must reside and be legal to work in the U.S.

  • Must be fully vaccinated against COVID-19 or can claim exemption based on medical reasons or religious beliefs

TECHNOLOGY REQUIREMENTS

  • Microsoft Word, Excel, & Outlook

  • Reliable high-speed internet service