Coder/Auditor II

Overview: Demonstrates proficiency in all aspects of outpatient coding.

Complies with all aspects of Coding and Corporate Compliance standards.

Abides by all ethical standards and adheres to official coding guidelines.

Performs other duties as assigned.

Essential Functions: Conducts physician chart audits to identify incorrect coding, prepares reports of findings and any compliance issues.

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.

Report coding patterns identified within the audit process to the Supervisor, and identify 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-9 materials, the Federal Register, and other pertinent materials.

Enhances professional growth and development through in-service meetings, educational programs, conferences, etc.

Maintains strictest confidentiality.

Assists in the preparation of training materials.

Performs related work and projects as required.

Education: CPC CCS-P, or CPMA certificationrequired.

High School diploma orequivalent .

Experience: Must have2-3 years of coding experience in a Primary Care environment.

Knowledge, Skills, and Abilities: Excellent understanding of medicalterminology, disease process and anatomy and physiology.

Strong understanding ofICD-9-CM coding classification.

Excellent understanding of CPTcoding within a Primary Care environment.

Knowledge of Risk Adjustment andHierarchical Condition Categories (HCC) and Medicare Advantage reimbursement aplus.

Strong Computer skills (i.

e.

MSOffice).

Good organizational skills andability to meet designated deadlines and productivity standards.

Ability to work well with all levelsof staff in a courteous, professional manner.

Strong interpersonal andcommunication skills.

Valid driver s license.

Ability to travel to variousclinics within Florida.

Bilingual aplus (English/Spanish).

DaVita Medical Group manages and operates medical groups and affiliated physician networks in California, Colorado, Florida, Nevada, New Mexico, Pennsylvania and Washington.

A leading independent medical group in America, DaVita Medical Group has over two decades of experience providing coordinated, outcomes-based medical care in a cost-effective manner.

As of December 31, 2016, DaVita Medical Group s teammates, employed clinicians and affiliated clinicians provided care for approximately 1.

7 million patients.

DaVita Medical Group s leadership development initiatives and social responsibility efforts have been recognized by Fortune, Modern Healthcare, Newsweek and WorldBlu.

DaVita Medical Group is an equal opportunity/affirmative action employer.

As such, DaVita Medical Group makes hiring decisions solely on the basis of and experience, and without regard to age, race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.

We maintain a drug-free workplace and perform pre-employment substance abuse testing and background verification checks.

DaVita Medical Group will consider qualified applicants who have criminal histories in a manner consistent with the law.

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