Randstad HIM Audit and Education specialist in Hartford, Connecticut
HIM Audit and Education specialist
Thursday, October 13, 2016
HIM Audit and Education Specialist develops, implements and maintains an effective and comprehensive audit and education program for coding consistent with regulatory, contractual , professional standards and healthcare revenue cycle industry practices. Reports to HIM Professional Coding Manager.
performs risk assessment and executes the professional audit work plan which includes internal and provider coding QA. Compiles and prepares reports for distribution to key stakeholders.
analyzes audit results, creates materials for education and performs education and training for providers and staff to ensure updates and quality assurance on coding.
Creates and trains on documentation templates designed for specialty/client , e.g. encounter forms, medical reports, monitoring/analysis reports, continuous auditing tools. ect. to insure appropriate documentation is captured for services rendered.
Identifies common issues and effectively communicates via memos and other documentation to disseminate compliance and audit culture and makes recommendations as appropriate to management.
Researches literature from regulator groups such as, HHS/OIG, Medicare, medicaid, NGS, ect. professional and peer organizations practices/policies/guidelines to keep organization current with regulatory requirements and accepted audit and education practices.
Coding Certification (CCS,CPC) ect. REQUIRED CPMA preferred Bachelors preferred.
Five years experience (preferred) with CPT, HCPCS and ICD-9 coding coding convention required. Experience with interpreting Medicare, medicaid, and third party billing and compliance regulations necessary. Experience with Claim Submission requirements preferred.
demonstrates experience analyzing data, review results and providing education to both clinical providers and coders in productive manner.
Experience with Word, Excel, and Powerpoint required. Knowledge of business system , e.g. SMS. IDX, etc. preferred.
exemplary communication skills; ability to navigate challenging conversations and provide effective provider training in large and small groups.