External Auditor Physician

Summary/Objective

Under general supervision of client Omegas External Auditor Physician will perform reviews of inpatient and outpatient or Professional Services medical records for coding accuracy and medical record documentation as it impacts the accuracy of ICD-10-CM ICD-10-PCS codes driving MS-DRG assignment and ICD-10-CM and CPT-4/HCPCS codes driving the APC assignment.The External Auditor Physician must be able to identify Physician query opportunities write compliant queries assess the accuracy of POA discharge disposition and modifier assignments.External Auditor Physician performs data collection for quality and statistical purposes and reports the findings to Omegas clients.

EssentialJob Functions

• Reviewinpatientoutpatientorphysicianservicesmedicalrecordsforaccuracyofcodinganddataquality. Elements to be included in reviews can include:

  Inpatient/ObservationCases

  • AlldiagnosisandprocedureassignedICD-10-CMandICD-10PCScodes

  • Dischargedispositionassigned

  • AssignedPresentonAdmission(POA)indicators

  • APRSOIandROMassignmentforinpatientcases Outpatient Cases (ER SDS Ancillary)

  • AlldiagnosisandprocedureassignedICD-10-CMandICD-10PCScodes

  • AllCPTassignedcodes

  • Modifieruseandassignment

  • APCassignment Professional Services

  • AlldiagnosiscodesassignedICD-10CM

  • AllCPT codes

  • AllE&MLevelingcodes

• MaintainauditingproductivitybasedonClientandOmegaagreeduponrequirements

• CompleteQualityReviewreportstimelyandsubmitstoClientforreview.

• Utilize all available official references to perform reviews: to include but not limited to International ClassificationofDiseases9thEditionClinicalModification(ICD-9-CM)theCurrentProceduralTerminology (CPT-4) Official Coding Guidelines Coding Clinic CPT Assistant CMS guidelines etc.

• Perform duties in compliance with Companys policies and procedures including but not limited to those related toHIPAA and compliance.

KeySuccess Indicators/Attributes

• Abilitytoprioritizeandmulti-taskinamultifacetedenvironment.

• Demonstratestrongorganizationalskillsandbedetailoriented.
• Demonstrateabilitytoself-motivatesetgoalsandmeetdeadlines.
• Demonstrateleadershipmentoringandinterpersonalskills.

Demonstrateexcellentpresentationverbalandwrittencommunicationskills.

• Abilitytodevelopandmaintainrelationshipswithkeybusinesspartnersbybuildingpersonalcredibilityand trust.

• Maintainscourteousandprofessionalworkingrelationshipswithemployeesatalllevelsoftheorganization.

• Demonstrateexcellentanalyticalcriticalthinkingandproblem-solvingskills.
• Abilitytoidentifydeficienciesandtakecorrectiveaction.
• Proficientpersonalcomputerskills

Supervisory Responsibility

No

WorkEnvironment

This job operates in a remote home office environment. This role routinely uses standard office equipment such as computers and phones.

PhysicalDemands

Thephysicaldemandsdescribedherearerepresentativeofthosethatmustbemetbyanemployeeto successfully perform the essential functions of this job.

While performing the duties of this job the employee is occasionally required to stand; walk; sit; use hands to fingerhandleorfeelobjectstoolsorcontrols;reachwithhandsandarms;climbstairs;balance;stoopkneel crouchorcrawl;andtalkorhear.Theemployeemustoccasionallyliftormoveupto25pounds.Specificvision abilities required by the job include close vision distance vision peripheral vision depth perception and the ability to adjust focus.

PositionType/ExpectedHoursof Work

This is a full-time position.Days and hours of work are generally Monday through Friday 8:00 a.m. to 5 p.m. This position occasionally requires long hours and weekend work.

Travel

Minimumtravelrequired;upto5%

RequiredEducationandExperience

• AssociatesDegreeorequivalenttrainingacquiredthroughon-the-jobexperience.

• Musthaveatleasttwoyearsof HIMexperiencepreferablyasan Auditor.

• Atleastoneyearofauditing experience.

• MinimumofsuccessfulcompletionofanAHIMAapprovedCodingCertificateProgram.

Preferred Education and Experience

None.

Additional Eligibility Qualifications

CCS CPC CPC-P CPC-H RHIA or RHIT

Security Access Requirements

In addition to the specific security access required by the employees client engagement the employee will have access to the Omega systems set forth in the Standard Field Employee profile.

Equal Employment Opportunity:

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race color religion national origin gender age sexual orientation gender identity or expression marital status mental or physical disability protected veteran status and genetic information or any other basis protected by applicable law. Omega Healthcarealso prohibits harassment of applicants or employees based on any of these protected categories.

Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application interview or any other part of the hiring process please contact Human Resources at.

OtherDuties
Pleasenotethisjobdescriptionisnotdesignedtocoverorcontainacomprehensivelistingofactivities dutiesorresponsibilitiesthatareoftheemployeeforthisjob.Dutiesresponsibilitiesand activitiesmaychangeatanytimewithorwithoutnotice.Employeemayperformotherdutiesasassigned.