Remote Profee Remote Auditor/Educator

About the role

Build your Career. Make a Difference. Presbyterian is hiring a skilled Profee Remote Auditor/Educator to join our team. Type of Opportunity: Full time Job Exempt: Yes Job is based: Remote Workers New Mexico Work Shift: Days (United States of America)

Responsibilities

• Some key responsibilities include:
• Assists in the creation of the CDQA Annual Audit Work-plan by utilizing the OIG work plan, Medicare and Medicaid regulations, RAC and other audit agency focuses, as well as internal and external risk assessments
• Regularly exercises independent judgment in determining the reliability of data reviewed; recommends changes in existing practices to gain or maintain compliant behavior. Keeps actively informed on the business climate of the healthcare industry
• Responds to inquiries and requests daily regarding coding and auditing issues and problems and ad-hoc analysis for all PHS management
• Maintains up-to-date working knowledge of all PHS coding and auditing IT applications
• Gathers and analyzes information and provides recommendations to address and resolve business issues for a specific business group
• Conducts training classes in areas of coding, documentation and compliance for PHS/PMG personnel. This includes preparation of training materials, educational audits and answering specific situational questions, ICD-10 education and EPIC EMR documentation education to providers and clinical staff
• Conducts systematic focused internal audits via medical record and charge ticket review to insure correct coding, billing and charging as member of CDQA audit team
• Analyzes and summarizes data from medical record and account audits and communicate results and findings to management and compliance. Develops new methods and processes to improve coding efficiency and effectiveness
• Researches and investigates external and internal customer concerns regarding patient care and/or billing of patient care. Ensures that coding functions are performed in accordance with established quality and performance standards by monitoring system generated reports and quality audits
• Working hours may vary based on projects assigned
• Must be able to travel to all of the PHS/PMG sites (including overnight). Travel varies at certain times based on assignments

Requirements

• High school diploma/GED required. Must possess at least one of the following license/certifications: R

Benefits

Additional Information

Location Address: Remote Office Santa Fe, NM 87501 Compensation Pay Range: Minimum Offer $57,241.60 Maximum Offer $87,422.40 Now Hiring: Remote Profee Remote Auditor/Educator

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