Providing advanced level auditing and teaching skills, serves as a resource to Documentation Auditor, retrieves and audits medical records to determine if billing reflects the care documented, implements controls to ensure compliance with medical coding standards, prepares audit reports, provides in-house consultation and training on current coding requirements and regulations; and other duties as assigned.

ESSENTIAL FUNCTIONS

• Applies knowledge of government regulations as they relate to the auditing of coding and payment of service.
• Ensures that appropriate procedural and diagnostic code based on provider documentation is used utilizing HIPAA Standardized Code Set and applying CMS/payor guidelines.
• Audits medical record and prepares audit reports to present to department. (Chairs, physicians, Administrators, compliance liaisons to review findings); schedule educational sessions with physicians. Must meet certain levels of audits in a year; must follow departmental time lines and guidelines for internal meetings.
• Monitors accuracy of own transactions; record transactions accurately; maintain accurate records; recognize and correct errors; ensure quality of work.

EDUCATION and/or EXPERIENCE

* Bachelor's degree in health care compliance or related field; or combination of education and experience may be considered
* Five or more years of coding experience; plus 2 years of multi-specialty auditing experience
* Must have CPC or CCS-P coding certification and must obtain CPMA within 1 year of hire date
* Strong knowledge of MS Office Suite (Excel, Word, Power Point)
* Strong computer skills
* Strong interpersonal communication skills
* Strong knowledge of CMS rules and regulations
* Familiarity with auditing software, MD audit preferred.

Note: The intent of this list of primary duties is to provide a representative summary of the major duties and responsibilities of this job. Incumbents perform other related duties as assigned. Specific duties and responsibilities may vary based upon departmental needs.

Total Rewards
The referenced base salary range represents the low and high end of University of Maryland’s Faculty Physician’s Inc. salary range for this position. Some candidates will not be eligible for the upper end of the salary range. Exact salary will ultimately depend on multiple factors, which may include the successful candidate's geographic location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/training and other qualifications. University of Maryland Faculty Physician’s Inc. offers a total rewards package that supports our employees' health, life, career and retirement. More information can be found here: https://www.umfpi.org/jobs/summary-employee-benefits