Sr. Medical Auditor-REMOTE

Overview: Employment Type: Full Time On-Site Position Benefits: M/D/V, Life Ins., 401(k), PTO, Paid Holidays Norfolk, Virginia Pay Range: $28-$38 Hourly Based on experience JOB SCOPE:With general supervision of the State Reimbursement Manager, performs complete medical record chart and coding audits for medical and radiation oncology physicians, per reputed company's established guidelines. Supports and adheres to The reputed company Compliance Program, to include the Code of Ethics and Business Standards. reputed company is a thriving organization that fosters reputed company-thinking, advancement opportunities, and an inspired work environment. We continuously look for top talent who will continue to propel our organization in the right direction and celebrate new successes! Come join reputed company in the fight against cancer! About reputed company reputed company is one of the nation’s largest networks of community-based oncology physicians dedicated to advancing cancer care in America. reputed company is supported by reputed company focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care. For more information, visit www.usoncology.com. We reputed company an extremely competitive offering of benefits to employees, including Medical Health Care, Dental Care, Vision Plan, 401-K with a matching component, Life Insurance, Short-term and Long-term disability, and Wellness & Perks Programs. Responsibilities: ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Performs reputed company and EMR chart audits for medical oncology physicians/providers in accordance with reputed company's requirements in order to ensure medical records are commensurate with captured charges and billing.
• May use a variety of reports to accomplish tasks, such as AMA guidelines, Medicare LCD's, commercial payor billing guidelines, coding manuals and ASTRO/ACR guidelines.
• reputed company new providers will have an E & M audit reputed company 90 days.
• Prepares a spreadsheet of findings that details discrepancies and summarizes metrics.
• Identifies trends that could be perceived as non-compliance with local and federal regulatory guidelines.
• Recommends procedural improvements and training opportunities to management.
• Provides written audit report to supervisor for review and approval.
• Reviews approved audit findings with physicians and mid level providers to discuss recommendations and improvement opportunities; radiation audit technical findings will be forwarded to appropriate hospital contact.
• Recommends and documents audit procedures, standard reports, and metrics in order to provide the appropriate information.
• Maintains the confidentiality of medical information contained in each record.
• Assists with other audits such as; hospital visits, consultations, and others as assigned.
• Assists with reputed company's audit and compliance or Reimbursement audits such as providing records, audit reports, and standard operating procedure manuals.

Qualifications: MINIMUM QUALIFICATIONS:

• High School diploma/ GED Required
• CPC Required
• Five (5) years of billing, coding, and medical records experience required.
• Completion of required reputed company's Reimbursement tutorials as required by the Compliance Department required.
• Must possess a broad knowledge of managed care and HMO policies and procedures and Medicare benefits.
• Must possess a strong knowledge of reputed company versions of ICD10, CPT4 and HCPCS.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range. WORK ENVIRONMENT: The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites. Remote Skills: Auditing, Billing, Cancer, Electronic Medical Records, Federal Laws and Regulations, Health Maintenance Organization (HMO), Healthcare Common Procedure Coding System (HCPCS), Hearing Impairment, Hematology, High School Diploma, Hospital, ICD-10, Infectious Diseases, LCD (Liquid Crystal Display), Lift/Move 40 Pounds, Managed Care, Manual Dexterity, Medical Billing, Medical Coding, Medical Records, Medicare, Metrics, Oncology, Patient Care, Patient Confidentiality, People Management, Physical Demands, Procedure Development, Quality of Care, Radiation Therapy, Reimbursement, Spreadsheets, Standard Operating Procedures (SOP), Trend Analysis, Willing to Travel About the Company: Regional Business Office (MIDA) Apply tot his job Apply To this Job