Profee Medical Audit / Education Specialist - R...

Remote: Medical Profee Audit & Education Specialist IKS Health is seeking to hire a Profee Audit & Education Specialist About IKS: 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