Interventional Radiology QA Auditor  

• Audits facility Interventional Radiology and Cardiovascular Interventional Radiology encounter code assignments. Review of medical records to determine coding accuracy of all documented diagnoses and procedures. Reviews claims to validate submitted codes and abstracted data including but not limited to ICD-10-CM codes, CPT’s, and HCPCS codes, which all impact reimbursement.
• Analyzes and interprets documentation from medical records
• Clearly documents audit findings and calculates coding error rates
• Provides feedback and education as appropriate based on audit findings
• Articulates audit findings appropriate to the audience. Prepare written audit analysis and summary reports, including corrective action necessary to mitigate risks
• Performs internal and or external Compliance client coding and auditor reviews
• Educates and audits coders and co - auditors.
• Stays abreast of relevant Outpatient coding and billing guidelines
• Researches, develops and presents education to client coders and auditors, based on individual audit analysis
• Conducts auditor peer review audits as requested
• Ability to prioritize multiple assignments and multiple spreadsheets, documents and reports
• Serves as a resource for interventional Outpatient Audits

• Professional Coding Experience in Interventional Radiology and Cardiovascular Interventional Radiology
• Ability to create clear and concise audit reports and maintain productivity standards
• Knowledge of medical terminology, ICD-10-CM, CPT, HCPCS coding guidelines and methodologies
• Knowledge of disease pathophysiology and drug utilization
• Must be detail oriented and have the ability to work independently
• Computer knowledge of MS Office
• Must display excellent interpersonal skills
• Ability to demonstrate initiative and discipline in time management and assignment completion
• Knowledge of NCCI/OCE billing edits as it relates to outpatient coding, auditing and billing
• Experience with various documentation and Electronic Medical Record systems.
• Experience in all Outpatient facility and professional chart types.
• Certified - CCS, CCS-P, CPC, COC, CPMA, CIRCC (Certified Interventional Radiology Cardiovascular Coder)