Professional Coding & Audit Specialist

Centra Health

Job Description:

The Professional Coding and Audit Specialist independently performs audits of Centra Medical Group(CMG) provider documentation and coding of Professional Evaluation & Management (E/M) services to include E/M, International Statistical Classification of Diseases and Related Health Problems, tenth version- Clinical Modification (ICD-10-CM), Current Procedural Terminology (CPT) codes and modifiers to determine accuracy based on current coding guidelines, regulatory requirements and billing rules related to coding. This position provides education and training to CMG providers and staff related to professional coding and documentation.

Required Qualifications:

Certified Professional Coder (CPC) or Certified Coding Specialists (CCS).

Note: In lieu of a CPC or CCS certification a Registered Health Information Technician (RHIT) or a Registered Health Information Administrator (RHIA) certification in conjunction with at least five years of experience in Professional Evaluation & Management coding will be acceptable.

Preferred Qualifications:

Certified Evaluation and Management Coder (CEMC) or Certified Professional Medical Auditor (CPMA) is preferred.

Education Qualifications:

High School diploma or equivalent required. Prior experience in Professional Evaluation & Management (E/M) coding.  Working knowledge of the 1995 and 1997 Evaluation & Management documentation guidelines, ICD-10- CM, CPT and HCPCS coding guidelines.

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