Overview
This position is responsible for auditing the accuracy of assigned diagnostic and procedure codes to records of patients; ensuring compliance with federal, state and regulatory requirements; payer requirements; and USAP policies and procedures; providing accurate, meaningful and timely audit reports and findings to management. This position is also responsible for communicating with management, and providers regarding audit results, new or revised documentation guidelines and other compliance related information as required.
Job Highlights
- Advanced knowledge of CPT, ASA, and ICD-10 codes, and Managed Care, Medicare, Medicaid and Workers Comp. billing and coding rules, regulations and guidance, as they relate to anesthesia.
- Self-motivated; Ability to work independently and receive limited instruction on daily work and general instructions on new assignments
- Substantial understanding of current auditing methods and procedures.
- Strong oral and written communications skills as well as excellent report writing skills.
- Strong data collection skills and propensity for analyzing data and finding discrepancies and errors. Strong critical thinking skills
- Intermediate to advanced research skills in gathering, researching and reporting information.
- Efficiency in time management, setting priorities and meeting deadlines. The ability to work on multiple projects and establish appropriate priorities.
- The ability to maintain confidential and sensitive information, including, but not limited to, patient records and audit reports.
- The ability to investigate, analyze and resolve non-routine issues and problems.
- Ability to work effectively with staff, providers, and department management in a pleasant, courteous and organized manner.
- Working knowledge of computers and ability to use word-processing, spreadsheet and data base programs.
- Effective organizational skills and strong attention to accuracy and detail.
- Must have a pleasant disposition and high tolerance level for diverse personalities.
Qualifications
EDUCATION/TRAINING/EXPERIENCE:
- High School diploma or equivalent is required, associate’s or bachelors’ degree in related field preferred.
- 4-5 years Anesthesia coding experience or equivalent combination of education and coding experience.
- Previous auditing experience preferred
- Certification in coding required (Certified Professional Coder, Certified Coding Specialist)
- Advanced certification as Certified Anesthesia and Pain Management Coder (CANPC)
- Certified Professional Medical Auditor (CPMA), or Certified Healthcare Auditor (CHA)
PHYSICAL REQUIREMENTS:
- Requires prolonged sitting, some bending, stooping and stretching.
- Requires eye-hand coordination and manual dexterity sufficient to operate keyboard, scanner, copier, telephone and other office equipment. Requires dexterity to type 35-50 WPM.
- Requires normal range of hearing and eyesight to record, prepare and communicate reports and application forms.
- Requires occasionally lifting papers or boxes weighing up to 35 pounds.
- May require travel to various USAP locations or facilities where USAP providers provide services.
WORKING CONDITIONS (environment and safety):
- Work performed in office environment or remotely.
- Involves frequent contact with professional staff and managed care organizations.
- Work may be stressful at times.
- Interaction with others is frequent and often disruptive
US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factor
