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Title

Outpatient Auditor 

Location Miami, FL  
Description

eCatalyst Healthcare Solutions is hiring immediately for an Outpatient (OP) Auditor to join our diverse and dynamic team of Health Information professionals.

As an Outpatient Auditor, you will perform auditing for one of our valued client partners. Our dedicated employees enjoy the collaboration and recognition of working in small teams to support our amazing clients.

Duties/Responsibilities:

  • Provide client services and lead, coordinate, and perform all functions of quality reviews for outpatient coding across multiple clients.
  • Performs quality reviews on coders ensuring compliance with coding guidelines and company policies for complete, accurate, and consistent coding.
  • Reviews include Outpatient ICD-10, CPT, APC, CPT Modifiers, ED E&M and professional coding and E&M assignments.
  • 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 coding guidelines.
  • Facility OP auditing including Same Day Surgery, Observation, ED, and Ancillary visit types. Profee multi-specialty experience is a plus.
  • 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.

eCatalyst offers an amazing work culture, supportive teams, and competitive benefits!

• United Healthcare Health plans with an extensive national network - 2 PPO plans and a HDHP with a Health Savings Account (HSA)

• 401k plan with an up to 4% company match

• Dental Insurance • Vision Insurance

• Paid Time Off (PTO)

• Company Paid Life Insurance and Long-Term Disability for all employees

• Company Paid Short Term Disability (for qualifying positions)

• Voluntary Life Insurance, Short Term Disability, Accident, Critical Illness and Hospital Indemnity Plans

• Pet Insurance

• Dependent Care and Medical Flexible Spending Accounts

• EAP and Financial Wellness programs

• Free Continuing Education Credits

 
Position Requirements

Minimum Requirements

  • 5+ years of coding experience.
  • 3+ years of auditing experience.
  • 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 (RHIT or CCS Preferred):

  • RHIT (Registered Health Information Technician)
  • CPC (Certified Professional Coder)
  • CCS-P (Certified Coding Specialist-Phys Based)
  • CCS (Certified Coding Specialist)
  • CMPA (Certified Professional Medical Auditor)
  • RHIA (Registered Health Information Administrator)
 
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.  
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.  

This position is currently accepting applications.

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