Professional Coding Educator/Auditor

Job description

JOB TITLE: Professional Coding Educator/Auditor

DEPARTMENT: Billing Department

STATUS: Full Time (Non- Exempt Hourly)

LOCATION: 696 Dutchess Turnpike Poughkeepsie NY 12603

REPORTS TO: Lead of Auditing and Provider Education

SHIFT/CORE HOURS: Monday-Friday 8:30AM-5:00PM



Exciting Careers Await at Premier Medical Group!



Who We Are

We are a physician-owned, multi-specialty medical practice with strong roots in the Hudson Valley.

At Premier Medical Group, we are dedicated to delivering outstanding, quality healthcare across our community and beyond.

Our large and diverse network is comprised of over 500 dedicated team members working across 16 locations, including a robust team of 100 providers offering care in 14 distinct specialties.



We pride ourselves on delivering the latest in advanced diagnostic and therapeutic services, compassionate care, and a team-oriented approach.

If you're passionate about making a difference and being part of a team committed to improving community health, we want YOU to join us!



Who You Are

You're a compassionate and results-oriented individual who thrives in a patient-centered healthcare environment! You're a skilled communicator, effortlessly connecting with patients, colleagues, physicians, and the public.

You possess strong critical thinking abilities and a positive outlook, tackling challenges with creativity and flexibility.

You're eager to contribute to the success of Premier Medical Group, embracing the opportunity to travel to different locations within our network as needed.



POSITION SUMMARY: The Professional Coding Educator/Auditor provides educational and physician support for coding and billing practices, performs annual provider audits, and provides continuing education in coding and billing of specialty services and third-party regulations.

This role will also act as a liaison between coding personnel and other staff groups—from clinicians to staff responsible for authorizations, billing, and denial management.



DUTIES AND RESPONSIBILITIES:


+ Maintains complete understanding of designated duties and responsibilities.

+ Primary accountability for completion of annual new hire, specialty-specific, and ad hoc audits as required, with expectation of 95% accuracy.

+ Focuses on potential documentation improvement opportunities and issues by specialty for E&M, surgical, and ancillary clinicians.

+ Collaborates with lead on creation and maintenance of education modules, including lesson plans and teaching materials for physicians, divisions, departments, as well as supporting providers such as PAs and NPs. (e.g. audiovisual aids, competency examinations, and presentations)

+ Works with Revenue Cycle leadership and Compliance determine areas of both risk and opportunity as well as provide information and training on regulatory updates and standards to physician, providers, and centralized billing staff.

+ Documents and maintains provider records to ensure annual/ new provider/ ad-hoc audits and training requirements are fulfilled.

+ Always maintains a professional demeanor with patients, co-workers, providers and all leadership.

+ Ability to use independent judgment and to manage and impart confidential information.

+ Ability to multi-task and manage priorities and meet critical deadlines.

+ Ability to work independently and in a fast-paced environment.

+ High level of awareness of pertinent details; excellent organizational skills

+ Accepts and integrates constructive criticism into daily work.

+ Promotes a positive cooperative team approach with excellent patient interaction and customer service.

+ Demonstrates regular, reliable, and predictable attendance.

+ May be asked to assist with special projects.

+ Maintain and model Premier Medical Groups mission, vision and Core values.



+ Patient-Centered: Provide compassionate care and excellent service.

+ Respectful: Respect co-workers and value each patient’s individuality and personal healthcare choices.

+ Engaged: Demonstrate commitment, enthusiasm, and a positive attitude toward our work.

+ Mentoring: Listen, share knowledge, and influence others in a positive way.

+ Integrity: Practice the highest ethical standards, display honesty, be accountable and treat others fairly.

+ Efficiency: Demonstrate proficiency in what we do; utilize time, resources, and finances appropriately.

+ Resilience: Adapt and respond quickly to opportunities and risks in order to manage change and grow.



+ Performs all other duties assigned.


EDUCATION AND WORK EXPERIENCE:

Bachelor’s degree in a relevant field; Experience may substitute for education requirement.

6 years of related experience in a healthcare setting, with 2 years experience in auditor role.

Certified Professional Coder (AAPC, AHIMA)- Required

Certified Medical Auditor Certification (AAPC)-Preferred or obtained within 1 year of job start date.



KNOWLEDGE AND SKILLS:

Federal laws and regulations affecting coding requirements.

Working knowledge of payor guidelines

Knowledge of revenue cycle and billing practices

Knowledge of Microsoft Suite Strong communication skills

Excellent interpersonal skills

Organizational skills

Denial Management



What we offer

• Comprehensive Medical, Dental, and Vision Coverage

• Voluntary Benefits (e.g., life insurance, disability)

• 22 paid time off days (including holidays) at start, with growth over time

• 401(k) with up to 5% Employer Contribution/Profit Sharing

• Education Assistance

• Employee Assistance Program (EAP) for mental health and wellness support

• ...And Much More!



Premier Medical Group is an Equal Opportunity Employer

Required Skill Profession

Other General