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Coder/Auditor II

Company: DaVita Medical Group
Location: Saint Petersburg
Posted on: September 15, 2019

Job Description:

OVERVIEW OF POSITION: The Coder-Auditor, II demonstrates proficiency in all aspects of outpatient coding.  The Coder-Auditor, II performs medical chart audits for evaluation, management, and documentation.  This role also interfaces and disseminates audit results to clinicians and management.  This role qualifies for remote status. ESSENTIAL FUNCTIONS: Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with each and every internal and external customer. Represents the Company in a professional manner, following all Company policies and procedures. Uses, protects, and discloses DaVita Medical Group patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards. Complies with all aspects of Coding and Corporate Compliance standards. Abides by all ethical standards and adheres to official coding guidelines. Conducts physician chart audits to identify incorrect coding, prepares reports of findings and any compliance issues. Reports coding patterns identified within the audit process to the Manager, and identifies corrective measures to compliance problems. Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-10 materials, the Federal Register, and other pertinent materials. Interacts with physicians and center administrators regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation. Provides second-level review of billing performances to ensure compliance with legal and procedural policies to ensure adherence to regulations prohibiting unbundling and other questionable practices. Enhances professional growth and development through in-service meetings, educational programs, conferences, etc. Assists in the preparation of training materials. Maintains confidentiality. Performs related work and projects as required. Performs other duties as assigned. Must have consistent, punctual and reliable attendance. Ability to travel up to 25% is required. EDUCATION: Must have a High School diploma, GED or equivalent. Certified Coder (based on specific organizations) Or equivalent EXPERIENCE: Must have 2-3 years of coding experience in a Primary Care environment. KNOWLEDGE, SKILLS, ABILITIES: Knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) and Medicare Advantage reimbursement a plus. Must have an excellent understanding of medical terminology, disease process and anatomy and physiology. Must have an excellent understanding of ICD-10-CM coding classification. Must have an excellent understanding of CPT coding within a Primary Care environment. Computer literate (e.g., MS Office). Must have good organizational and communication skills. Must be task oriented and able to meet designated deadlines and productivity standards. Must have strong Interpersonal skills and excellent customer service skills. Ability to present a professional image when interacting with all levels of staff. A current, valid Florida driver’s license and ability to conduct local travel as needed. Ability to read, write, speak, and understand the English language fluently. What's the first thing that happens when one of the leading independent medical groups in the country comes together with a global leader in health care? Opportunity. With  DaVita Medical Group, HealthCare Partners, The Everett Clinic, Northwest Physicians Network, MountainView Medical Group and Magan Medical Clinic joining  OptumCare  and the  UnitedHealth Group  family of companies, people like you will find increasing levels of challenge, impact and professional success. We're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting opportunity to do your life's best work.(SM) Careers with OptumCare. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. OptumCare, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Here you’ll find incredible ideas in one incredible company and a singular opportunity to do your life's best work.(SM) Diversity creates a healthier atmosphere: OptumCare and its affiliated medical practices are Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. OptumCare and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: DaVita Medical Group, St. Petersburg , Coder/Auditor II, Other , Saint Petersburg, Florida

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