ModMed

Auditor

• Responsible for analyzing, reviewing and providing feedback when performing quality assurance activities and completing QA audits, including but not limited to: Ensuring all federal and state coding guidelines and regulations are met as well as payer guidelines
• Provide effective feedback to the global coding teams to aid in their successful coding of BOOST clients
• Maintaining a communication log to show successful training of the global coding team when coding trends or issues are found
• Report all coding trends and issues to the department lead as they are identified
• Review target cases per month based on the ModMed Quality Assurance SOP
• Accurately document their daily audit results in the Daily Audit Log and communicate coding resolutions to the BOOST or global coding teams
• Collaborate with the global coding teams on inquiries, clarifications, QA rebuttals and training requests
• Work alongside coding leadership in regards to global coding teams training of coding processes as well as attending remote coding sessions with the global coding teams
• Help with other daily communications between the internal BOOST RCM teams and the Auditing team in regards to other coding inquiries or issues
• Perform BOOST special Quality Assurance audits on the global coding teams
• Perform BOOST or Compliance audits when requested by BOOST or other ModMed staff which help to determine coding compliance or client documentation issues
• Support in the review, appeal and follow-up of third-party (RAC, CERT, etc.) audits
• Assist in review and maintenance of coding guidelines, coding scrub edits and/or practice coding instructions and assist with continuous quality improvement by helping with the process of implementation and carry through of coding protocols and procedures
• Collaborate with fellow coding/auditing team members to maintain department compliance and effectiveness
• Responsible for obtaining continuing education units (CEU) for maintaining coding certification(s)

Medical Coding Auditor