Medical Coding Auditor - Remote

Under the direct supervision of the Director and/or Manager of Medical Coding Audit and Education, the Medical Coding Auditor/Educator will be assigned one or more of the following responsibilities: accurate and compliant coding and documentation review of pertinent medical records and physician services to identify need for coding education; coding education to physicians, coders, and other staff involved in the coding and billing process. Coding reviews include routine and periodic assessment of diagnoses and procedures performed with adherence to established coding guidelines of ICD-9-CM and/or ICD-10-CM (International Classification of Disease), CPT (Current Procedural Terminology), Governmental and Third-party carriers. MCAE will participate in educational feedback loop with physicians, coders, and billers as necessary and according to procedure. To perform this job successfully, an individual must be able to evaluate, prepare, and present audit results and educational instruction to physicians, coders, and other staff using corporate approved audit and education tools and materials. Application software used to perform job's tasks includes internal database programs, NextGen EHR/EPM, GoTo Meeting, MicroSoft PowerPoint, Excel and Word, FirstClass.

JOB RESPONSIBILITIES/DUTIES:

• Assists in the formulation of division medical coding audit and education plans, materials and improvement processes.
• Reviews clinical documentation to determine adherence to established Government and third party billing guidelines, AMA, AAP, CMS, and Pediatrix Algorithms and coding policies as necessary.
• Following Medical Coding Audit and Education policies and procedures, provides medical coding education to ensure compliant coding practices for Pediatrix
• Provides coding education instruction to physicians, coders, and other staff regarding standards for medical record documentation and the correct use of CPT-4 and ICD-10 codes.
• Assists in the development and maintenance of Committee approved standardized coding education materials.
• Develops reviews and recommends changes to audit and education documents and templates as needed to enhance the overall auditing and education process.
• Evaluates coding requirements and prepares materials for physicians and their staff prior to coding education instruction sessions in an effective and timely manner.
• Produces accurate information when answering coding inquiries and formulating instructional session summaries.
• Performs miscellaneous compliance audits and company based audit and education projects as required or requested by senior management.
• Effectively resolves coding inquiry issues through participation in the coder email process, patient dispute resolution process, and general coding education emails.
• Participate in audit, education and coding team meetings to discuss solutions to coding guidance or presentation issues.

• Performs and meets administrative responsibilities according to company policies.
• Performs a variety of other duties as requested.
• Meets or exceeds required departmental deadlines and goals on a consistent basis.
• Maintains strict confidentiality in accordance with HIPAA regulations and Company policy.
• Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties.
• Embodies the principles of the corporate Mission Statement and Philosophy at all times.
• Complies with departmental and company-wide policies and procedures.

Effective November 1^st, 2021 Pediatrix will require all employees and new hires to be vaccinated against COVID-19, unless they qualify for an approved medical and/or religious exemption.

• Certified Professional Coder (CPC), Certified Coding Specialist - Physician (CCS-P) designation required with current active status.
• Level of educational degree and years of experience in hospital administration and/or multi-specialty physician practice, with full exposure to managing the accounts receivables, physician billing, and CPT-4/ICD-10 coding with medical terminology will identify the appropriate candidate.
• The following ratio of educational degree and years of experience will apply:
• Degree / Years of Experience
• High School Diploma 10 years
• Associate's Degree 7 years
• Bachelor's Degree 5 years
• Master's Degree 3 years
• Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions and communicate them to physicians, coders, and other staff in a way that facilitates understanding.
• Travel - this position may require travel to medical offices across an assigned geography as necessary. Travel will range from 25% to 50% each month dependent upon audit and education schedules. (Travel is reimbursed 100% by the company)

Benefits for Full Time employee and qualified dependents:

• Health Insurance including prescription drugs
• Dental Insurance
• Vision Insurance
• Life Insurance
• Short- and Long-Term disability options
• Employee stock purchase program - 15% discount*
• 401k with company match**
• Long Term Care (LTC)
• Pre-tax Health Savings Account (HSA)
• Pre-tax Flexible Spending Accounts (FSA)
• Aflac Hospital, Critical Illness and Accident plans
• Identity Protection
• Employee Assistance Program (EAP)

*Part Time Regular employee classifications also receive this benefit.

** Available to part-time regular and part-time casual employees age 21 and over.

Pediatrix Medical Group, Inc. (Pediatrix) is the nation's leading provider of physician services. Pediatrix-affiliated clinicians are committed to providing coordinated, compassionate and clinically excellent services to women, babies and children across the continuum of care, both in hospital settings and office-based practices. Specialties include obstetrics, maternal-fetal medicine and neonatology complemented by more than 20 pediatric subspecialties, as well as pediatric primary and urgent care clinics. The group's high-quality, evidence-based care is bolstered by significant investments in research, education, quality-improvement and safety initiatives. The physician-led company was founded in 1979 as a single neonatology practice and today provides its highly specialized and often critical care services through more than 5,000 affiliated physicians and other clinicians in 37 states.

Please Note: Fraudulent job postings/job scams are becoming increasingly common. All genuine Pediatrix job postings can be found through the Pediatrix Careers site: .

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

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