Pro Fee Auditor - Certified

Job Summary

A company is looking for a Pro Fee / Pro Clinic Auditor.

Key Responsibilities:

• Audit Inpatient, Same Day Surgery, Observation, and Pro Clinic charts
• Specialize in at least three of the following areas: Primary Care, Rural Health Clinics, Cardiology, Obstetrics, Behavioral Health, IVR, General Surgery, Spinal Surgeries, or Podiatry
• Identify potential risks to clients by auditing coders and providers for compliance with accuracy standards

Required Qualifications:

• Minimum of 3 years' experience in auditing Inpatient, Same Day Surgery, Observation, and Pro Clinic charts
• Extensive knowledge of coding and auditing principles, including incident-to guidelines and split/shared billing
• Proficiency in CMS and LCD guidelines
• Required certification from AHIMA or AAPC (CPC, CCS-P, CPMA, RHIT, RHIA)
• Demonstrated skill in medical necessity assessments