Overview:
Performs compliance audits based on current CMS, CPT, ICD-10 guidelines, as well as all state and federal regulations. Utilizes the CMS 95/97 or 2021 documentation guidelines for evaluation and management (E&M) reviews. Writes and presents concise recommendation worksheets with appropriate findings and references to clients during summation calls. Writes Executive Summaries and must communicate with different levels within the practice/facility. Utilizes review databases (Intelicode, MD Audit, etc).

Required Skills and Experience:
• High School diploma with at least one AAPC credential; CPC preferred
• Minimum 5 years review experience in a multispecialty clinic/facility
• ICD-10-CM training • Computer proficiency, able to research coding questions and utilize HIA’s internal educational resources
• Experience using Electronic Health Record (EHR)
• Independent, focused individual able to work remotely.
• Sound organizational, communication and critical thinking skills

Responsibilities:

Client Relations:
• Maintains adequate communication with client throughout the review process to ensure review goals and objectives are met

• Leads organized summation conference in an approachable, educational manner for client staff

• Provides ongoing educational support to client staff between scheduled reviews by researching issues and responding promptly to client inquiries Performance and Professionalism

• Maintains strict confidentiality and adheres to HIPAA guidelines

• Exhibits professional demeanor at all times

• Maintains communication by responding promptly to Corporate office staff

• Demonstrates flexibility, open mindedness, and versatility in adjusting to changing environments

• Handles constructive feedback with a positive attitude • Receptive to suggestions for changing or improving the way work is accomplished

• Commits to continually improving his/her job skills (i.e. attends educational meetings