Revenue Integrity Coding Auditor - Physicians East : Job Details

Job Title: Revenue Integrity Coding Auditor

FLSA: Non-Exempt

We are looking for an exceptional Revenue Integrity Coding Auditor to join our practice!

Physicians East, PA is a multi-specialty, multi-campus group based out of Greenville, NC offering a wide range of specialties. In addition to primary care the practice offers pulmonary and critical care medicine, rheumatology, dermatology, oncology, endocrinology, cardiology, obstetrics and gynecology, gastroenterology, surgery, urology, and urgent care. Our 102 providers and over 600 employees provide services for thousands of patients in a 29-county region. Our specialists are on staff at ECU Health, a 900+ bed, level one trauma center and the primary teaching hospital for the East Carolina University Brody School of Medicine (ECU-BSOM).

Located in the coastal plain area, only one hour from the Atlantic Ocean, Greenville is the vital center of business, industry, culture, education, and health care for eastern North Carolina. Its incomparable quality of life, the hospitality of its people, its modern outlook and interstate accessibility has contributed to the city's rapid growth. It has become a premier location to raise a family and enjoy a high quality of life. The mild climate and access to rivers and the ocean allows its residents to enjoy water sports, golf, tennis, and other sports, outside year-round.

Some of the benefits you will enjoy at Physicians East!

Comprehensive Medical and Prescription Drug Plan

Reduced co-pays for those that utilize Physicians East Medical Providers!

Convenient onsite employee pharmacy that offers reduced co-pays!

Dental insurance

Vision insurance

Critical illness, and other supplemental insurance plans available with payroll deduction!

Employee assistance program at no cost to employee and covered dependents!

Competitive long-term and short-term disability plans!

Life insurance provided at no cost to the employee with options to purchase additional protection for you and your family!

401(k) with generous company matching contributions!

Profit Sharing Program!

Flex Spending Account

Company Paid Short Term Disability Insurance

Company Paid Long Term Disability Insurance

Generous PTO program to provide our employees with essential work/ life balance!

Paid holidays in addition to accrued PTO!

Convenient parking onsite and close to where you work!

Employee Discounts Programs to save you money

About us

Physicians East, P.A.is a team of skilled healthcare professionals united to meet the challenge of delivering quality, cost-efficient, comprehensive healthcare to the people of Eastern North Carolina.

About the role

We are seeking a skilled Revenue Integrity Coding Auditor focused on revenue optimization to join our team. This position involves conducting detailed audits of coding practices, identifying areas for improvement, and ensuring compliance with industry standards. The ideal candidate will be proactive in uncovering missing revenue opportunities and will collaborate closely with coding and clinical teams to implement best practices.

Supervision Received: Reports to Regulatory Services Manager.

Supervision Exercised: none.

Typical Physical Demands: Requires prolonged standing or sitting while working in an office environment. Requires some bending or stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, and other office equipment. Requires the ability to distinguish between letters and/or symbols. Requires normal vision range and the absence of color-blindness.

Typical Working Conditions:

Flexible remote position with occasional onsite requirement.

Responsibilities

• Conduct thorough audits of coding practices to ensure compliance with ICD-10, CPT, and HCPCS guidelines.
• Analyze coding data to identify patterns of under coding, over coding, and missed revenue opportunities.
• Collaborate with coding and clinical teams to address identified issues and implement best practices for accurate coding.
• Develop and present educational materials and training sessions for coding staff to enhance their knowledge of revenue optimization and compliance.
• Analyze denials to identify trends for revenue optimization
• Stay current on coding regulations, payer guidelines, and industry standards to ensure the organizations adherence.
• Prepare detailed reports on audit findings, highlighting opportunities for revenue recovery and recommendations for improvement.
• Support the implementation of policies and procedures that promote best practices in coding and revenue integrity.
• Maintain confidentiality and comply with all regulatory and compliance requirements.
• Complete any other assignment, project, or priority as directed by Regulatory Services Manager

Location & commitments

Permanent full-time role

Remote position with occasional onsite requirement

Flexible schedule

Occasional overtime may be required to meet department goals

Candidate must be located in North Carolina

Candidate requirements

Must be an expert on ICD-10 and CPT, E/M, HCPCS coding systems.

5 Years coding experience

2+ years auditing experience

Ideally, at least two active coding credentials: CCS, CCS-P, CPC, CPMA, CDIP, RHIT and/or RHIA

Preferred Candidate will have CDI experience

Must have strong keyboarding, software, analytical and organizational skills. Must possess strong understanding of customer service principles and have well-developed written and oral skills.

Affirmative Action/EEO statement

Physicians East, P.A.is an equal opportunity employer and will not discriminate against any applicant or employee on the basis of age, race, color, ethnicity, religion, creed, sex (including gender, pregnancy, sexual orientation, and gender identity, which includes status as a transgender individual), national origin or ancestry, citizenship, past, current, or prospective service in the uniformed services, genetic information (including family medical history), physical or mental disability, or other legally protected status. Reasonable accommodation will be made for persons with disabilities during the application process and/or at the time of employment. Requests for accommodation should be made to the Human Resources Department as early as possible in the application/employment process. Contact HR Office at 252-###-#### or email [email protected]

Disclaimer

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

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