ProFee and Facility Outpatient Auditor

STAR Medical Auditing Services, LLC

Introduction:

STAR Medical Auditing Services was founded in 2016 with the mission to provide quality coding and audit services for healthcare facilities, private clinics and other agencies. In addition, the company also provides coding education and bootcamps for coding professionals. Our team of professional medical coders and auditors combined has over 50 years of experience in the field.

Job Description:

As a ProFee & Facility Outpatient Auditor you will be assisting STAR with medical auditing for our clients. Must have strong auditing skills with experience in multiple specialties and settings. We will train on client specifics however you are expected to have a thorough understanding of general auditing principles and procedures including outpatient coding guidelines. Experience with multiple EMR’s is preferred. Must have strong attention to detail with 95% or higher quality maintained. Coding assessments are required to be considered for this position. This is a contract position that is fully remote. Must work a minimum of 20 hours per week. Must be US-based.

RESPONSIBILITIES

  • Reviews medical records to identify diagnoses, CPT procedures and modifiers relative to the patient’s encounter.
  • Abstracts appropriate information from the medical record based on the guidelines provided by the client and after a thorough review of the medical record.
  • Solicits clarification from the physician regarding ambiguous or conflicting documentation in the medical record using guidelines provided by the client.
  • Ensure all coding complies with the ethical coding standards/guidelines and regulatory requirements.
  • Maintains strictest confidentiality; adheres to all Health Insurance Portability and Accountability Act guidelines/regulations
  • Completion of audits for multiple clients and projects requiring following specific client policies and procedures

EXPERIENCE/QUALIFICATIONS

  • Must have one of the following AHIMA/AAPC certifications: CPC, CCS, RHIA, RHIT.
  • Extensive knowledge of medical terminology, anatomy and coding guidelines for ICD-10, CPT, HCPCS and E/M codes
  • At least 2 years of recent active auditing experience in ProFee & Facility Coding including but not limited to:
    • ProFee E/M for ED, New and Established office Visit, Inpatient and Observation
    • Facility E/M for ED and Clinic
    • Facility Observation Hours
    • ProFee E/M for Nursing Facility Visits preferred
    • Minor Procedures done in office or ED
    • Infusions, injections, vaccinations & immunizations (adult & peds)
    • Modifier usage
    • NCCI Edits
  • Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures, and documentation including CMS guidelines
  • Maintains strictest confidentiality; adheres to all Health Insurance Portability and Accountability Act guidelines/regulations
  • Proficient computer skills using MS Word, Excel, Outlook and Internet Explorer, electronic medical records (EMR) systems including Epic, Cerner, Meditech, EMA, Athena, etc. along with computer-assisted coding programs.
  • Meet required client productivity standards and maintain minimum of 95% accuracy
  • Self-sufficient with strong analytical and research skills
  • Responsible and responsive
  • Strong attention to details
  • Excellent written and oral communication skills
  • Ability to meet deadlines
  • Must reside and be legal to work in the U.S.
  • Must be fully vaccinated against COVID-19 or can claim exemption based on medical reasons or religious beliefs

Education Qualifications:

Must have one of the following AHIMA/AAPC certifications: CPC, CCS, RHIA, RHIT.

Compensation/Benefits:

Pay: $25.00 – $30.00 per hour.

Instructions for Resume Submission:

Please submit your resume to STAR Medical Auditing Services at: https://www.starauditing.com/.

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