Position: Senior Clinical Coding Quality Auditor
Department: FPF Prof. Billing Office
Schedule: Full Time
POSITION SUMMARY:
The Senior Clinical Coding Quality Auditor conducts independent audits of Emergency/Observation and Outpatient professional fee services. Assures appropriate and accurate coding assignments in accordance with federal coding regulations and guidelines. Prepares written reports of findings and leads meetings with providers to review the audit findings and recommend ways to improve when indicated. Also responsible for providing assistance with coding inquiries from providers, coding, staff, etc. This position requires knowledge of applicable regulations for Medicaid and Medicare, as well as the principles of physician documentation, coding, and billing in a variety of settings and specialties. Also required is advanced knowledge of CPT, ICD-10-CM, and HCPCS coding systems. Responsibilities also include providing ICD-10-CM and EMR documentation training to physicians.
JOB REQUIREMENTS
EDUCATION:
Associates Degree (or direct work experience equivalent to at least 2 years)
CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:
Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is required. Certification may include CPC, COC, COC-A, CIC, CCA, CPC-A, CCS, CCS-P, RHIT, or RHIA
EXPERIENCE:
Minimum of 2 years experience conducting high complexity Emergency, Observation and Outpatient coding/auditing to include compliance, and billing processes.
KNOWLEDGE AND SKILLS:
ESSENTIAL RESPONSIBILITIES / DUTIES:
Must adhere to all of BMC’s RESPECT behavioral standards.
(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).
Equal Opportunity Employer/Disabled/Veterans
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EEO & Accommodation Statement
Boston Medical Center is an equal employment/affirmative action employer. We ensure equal employment opportunities for all, without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic.
If you need accommodation for any part of the application process because of a medical condition or disability, please send an e-mail to Talentacquisition@bmc.org or call 617-638-8582 to let us know the nature of your request
E-Verify Program
Boston Medical Center participates in the Electronic Employment Verification Program. As an E-Verify employer, prospective employees of BMC must complete a background check and receive medical clearance before beginning their employment at the hospital.
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