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Title

Multi-Specialty Professional Fee Auditor (Remote) 

EOE Statement eCatalyst Healthcare Solutions, Inc. is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.  
Description

Location: Remote

Schedule: FT Hourly Employee

Benefits:

  • Medical, Dental, Vision Insurance
  • 401(K) with Employer Match
  • Life Insurance
  • FSA Plans
  • Employee Assistance Program (EAP)
  • CEU’s and Continuing Education
  • And more!

 

Job Summary

eCatalyst Healthcare Solutions’ (“eCatalyst”) is actively hiring Professional Fee (PB) Auditors to join our diverse and dynamic team of Health Information professionals.

As a Professional Fee Auditor, you will perform auditing for one of our valued client partners.

Duties/Responsibilities:

  • Provide client services and lead, coordinate, and perform all functions of quality reviews for PB coding across multiple clients in multiple specialty groups and settings.
  • The PB Auditor performs quality reviews on coders ensuring compliance with coding guidelines and company policies for complete, accurate, and consistent coding.
  • The Professional Fee Auditor will assign and sequence ICD-10, CPT/HCPCS Level II codes, including E/M leveling, and all appropriate modifiers through review of documentation and diagnostic results as appropriate for billing, internal and external reporting, research, and regulatory compliance.
  • Knowledge expert and maintains up-to-date working knowledge of coding guidelines in order to act as a resource and point person for issues and question for coders, customers, or project teams.
  • Provides education to audit clients or internal eCatalyst coders as required by the deliverables of the contract.
  • Reviews physician documentation for coding appropriateness and accuracy following AMA and other national and state approved coding and billing guidelines.
  • Knowledge of billing/edit practices preferred.
  • Reviews and analyzes medical records for accurate code selection.
  • Provides feedback to coders and providers on coding corrections, appropriately citing authoritative resources.
  • Assists with the interpretation of codes and other information requested for accurate code assignment.
  • Communicate with management regarding clinical, coding, and reimbursement issues as needed.
  • Function in a professional, efficient, and positive manner with strong critical thinking and decision-making skills.
  • Utilizes our client’s electronic medical record (EMR), encoder, and computer-assisted coding (CAC) software as directed.
  • Ensures optimal reimbursement while maintaining compliance with CMS and third-party payor policies and guidelines.
  • Maintains compliance with eCatalyst and client’s coding policies, procedures, and guidelines.
  • Consistently maintains 95% or above accuracy rate while meeting established productivity standards.
  • Completes daily production log and daily time keeping requirements.
  • Attends and participates in eCatalyst and client meetings as requested.
  • Completes coding continuing education and maintains auditing credentials.
  • Ensures HIPAA compliance at all times.
  • Consistently delivers eCatalyst’s brand promise of “Exceptional Services Delivered with Unrelenting Client Focus” to our client partners.
 
Position Requirements

Minimum Requirements

  • 5+ years of coding experience.
  • 5+ years of professional fee auditing experience.
  • 3-5+ years auditing the following specialties:
    • Breast Care
    • Cancer Care
    • Cardiology
    • Cardiothoracic Surgery
    • Colon & Rectal Care
    • Gastroenterology
    • General Surgery
    • Maternal-Fetal Medicine
    • Neurosurgery
    • Orthopedics
    • Pain Management
    • Pediatrics
    • Post-Acute Care
    • Primary Care
    • Pulmonary Services
    • Thoracic Surgery
    • Urogynecology
    • Women's Health
  • 2+ years of experience directly educating providers
  • Experience with physician clinic auditing required and hospital facility clinic auditing is preferred.
  • Experience working in a coding vendor company or large hospital system is preferred.
  • Proficiency in multiple EMR’s, encoders, and the Microsoft Office suite.
  • Educated in HIPAA regulations; must maintain strict confidentiality of patient and client information.
  • Consistently achieves quality and productivity standards.
  • Ability to organize and complete work in a timely manner.
  • Ability to read, write and effectively communicate in English.
  • Ability to understand medical/surgical terminology.
  • Above average written and verbal communication skills.

 

Required Certifications

Candidates must have and keep current at least one of the following professional certifications:

  • CCS-P (Certified Coding Specialist-Phys Based)
  • CCS (Certified Coding Specialist)
 
Full-Time/Part-Time Full-Time  
About the Organization eCatalyst Healthcare Solutions is proud to be one of the nation's top HIM and Middle Revenue Cycle companies. Our expertise includes coding, auditing, clinical documentation improvement (CDI), master patient index, registry, revenue cycle, staffing, consulting, and more. eCatalyst is distinguished by our highly experienced and credentialed team and our unrelenting client focus.  

This position is currently accepting applications.

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