Pro Fee Audit Educator
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Job Location:
Linthicum, MD - USA
Monthly Salary:
Not Disclosed
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
Conduct independent compliance audits and review on the adequacy of medical record documentation to support the codes selected by providers and/or coders. Verify compliance with CMS guidelines CPT HCPCS and ICD-10 standardized code sets and internal coding and billing policies via documentation and coding review audits. Assist with reporting audit results trending and tracking regulatory updates responding to compliance inquiries preparing education materials and providing compliance educational support and training to providers and/or coders. Perform compliance documentation and coding audits using departments MDaudit software. Analyze documentation and/or coding patterns by a provider division or department that poses a compliance risk and provide recommendations to mitigate risks. JOB DESCRIPTION Page 2 of 5 Present audit findings and recommendations to key stakeholders including but not limited to individual providers provider groups and practice administrators. Develop and administer training and educational materials to address documentation and coding deficiencies identified in audits; support the development and administration of system-wide compliance education (e.g. New Provider Compliance Education and Annual Compliance Education). Prepare reports for the Chief Compliance Audit and Provider Officer Vice President Compliance Operations Director Revenue Cycle Billing and Coding Compliance Manager Coding Compliance and Training UMMS Executive Management and the Audit and Compliance Committee of the Board of Directors. Conduct regulatory research prepare draft responses to compliance inquiries for providers administrators and management. Monitor track and report regulatory updates regarding government billing and coding regulations. Log compliance incidents inquiries and investigations and supporting documentation in departments case management system; complete assigned cases. Support compliance investigations. Draft policies standard operating procedures and prepare tools (e.g. toolkits checklists). Meet department key performance indicators including but not limited to case turnaround time audit productivity and quality metrics. Perform other duties as assigned.
Qualifications :
High school diploma. Five (5) years experience in coding including two (2) years of auditing/billing compliance experience. Certified Professional Coder (CPC) certification Experience in and working knowledge of Corporate Compliance. Certified Coding Specialist (CCS) Certified Coding Specialist-Physician-based (CCS-P) or Certified Medical Auditor (CPMA) certification
Additional Information :
All your information will be kept confidential according to EEO guidelines.
Compensation:
Pay Range: $31.78 - $44.50
Other Compensation (if applicable):
Review the 2025-2026 UMMS Benefits Guide
Remote Work :
No
Employment Type :
Full-time
Key Skills
- Early Childhood Education
- Algebra
- Classroom Experience
- Lesson Planning
- Special Education
- Adult Education
- Special Needs
- Calculus
- Teaching
- Geometry
- Experience with Children
- Public Speaking
About Company
When you come to the University of Maryland St. Joseph Medical Center, youre coming to more than simply a beautiful 37-acre, 218-bed suburban Baltimore, Maryland campus. Youre embarking on a professional journey that encourages opportunities, values a team atmosphere, and makes conv ... View more
