AMN Healthcare
Remote Facility Outpatient Auditor
The OP Auditor will be responsible for auditing all types of Facility Claims Edits pre-bill out of multiple systems after the account has been completed by the production coder or AI software system. This candidate should have a strong background with Auditing the medical record documentation and complete all types of Edits. This candidate needs experience with most of these types of edits as well as billing understanding. Required Skills: NCD/LCD Medical Necessity Edits MUE edits OP-10, OP-8, OP-13, OP-39 Preferred MAC: Nordian (Jurisdiction JE) experience Laterality edits Manifestation code/First-listed Dx edits SDS Coding experience (including IVR) Longitudinal Medical Record knowledge NCCI edits (P2P, etc.) CPT vs. Device code edits Internal Keck edits (Missing procedure, LAB edits) OP Facility Auditor will need to have a strong working knowledge of CPT, ICD-10, HCPCS, and Modifiers coding principles. Knowledge of medical/surgical terminology. Job standards are expected to be performed at the expert level. Minimum Qualifications:
Must have a High School Diploma; or equivalent combination of education and experience. Two (2) years recent OP Facility Auditing experience. Expert with OP Facility Coding Guidelines. Expert knowledge in ICD10-CM and ICD-10-PCS, CPT, HCPCS coding principles. Experience writing appeals. Trauma 1 teaching facility experience. Experience working edits in a dedicated edit work queue. Experience dealing with/understanding insurance policies. Attention to detail. Excellent time management skills. Ability to multitask. Excellent written and verbal communication. Understanding of the Revenue Cycle. Insurance Billing experience may be helpful. Preferred Qualifications:
Cerner/PowerChart and 3M HDM experience - Not necessary but preferred. Four (4) years recent facility outpatient auditing - Claims Edit, Interventional Radiology, Ambulatory Surgery, Observation and Ancillary coding experience. Experience working denials IP/OP. Extensive coding experience, IP and OP preferred. Working Hours Needed:
M
F 8hrs per day, 40hrs a week M-F Business Hours PST. Flexible hours, once gotten through the initial audit. Compensation & Benefits:
Health & Dental, PTO, Sick Time, 6 paid holidays, 401K, HAS, Weekly Pay.
The OP Auditor will be responsible for auditing all types of Facility Claims Edits pre-bill out of multiple systems after the account has been completed by the production coder or AI software system. This candidate should have a strong background with Auditing the medical record documentation and complete all types of Edits. This candidate needs experience with most of these types of edits as well as billing understanding. Required Skills: NCD/LCD Medical Necessity Edits MUE edits OP-10, OP-8, OP-13, OP-39 Preferred MAC: Nordian (Jurisdiction JE) experience Laterality edits Manifestation code/First-listed Dx edits SDS Coding experience (including IVR) Longitudinal Medical Record knowledge NCCI edits (P2P, etc.) CPT vs. Device code edits Internal Keck edits (Missing procedure, LAB edits) OP Facility Auditor will need to have a strong working knowledge of CPT, ICD-10, HCPCS, and Modifiers coding principles. Knowledge of medical/surgical terminology. Job standards are expected to be performed at the expert level. Minimum Qualifications:
Must have a High School Diploma; or equivalent combination of education and experience. Two (2) years recent OP Facility Auditing experience. Expert with OP Facility Coding Guidelines. Expert knowledge in ICD10-CM and ICD-10-PCS, CPT, HCPCS coding principles. Experience writing appeals. Trauma 1 teaching facility experience. Experience working edits in a dedicated edit work queue. Experience dealing with/understanding insurance policies. Attention to detail. Excellent time management skills. Ability to multitask. Excellent written and verbal communication. Understanding of the Revenue Cycle. Insurance Billing experience may be helpful. Preferred Qualifications:
Cerner/PowerChart and 3M HDM experience - Not necessary but preferred. Four (4) years recent facility outpatient auditing - Claims Edit, Interventional Radiology, Ambulatory Surgery, Observation and Ancillary coding experience. Experience working denials IP/OP. Extensive coding experience, IP and OP preferred. Working Hours Needed:
M
F 8hrs per day, 40hrs a week M-F Business Hours PST. Flexible hours, once gotten through the initial audit. Compensation & Benefits:
Health & Dental, PTO, Sick Time, 6 paid holidays, 401K, HAS, Weekly Pay.