Description

ProFee Behavioral Health - Audit Team Lead (Remote)

STAR Medical Auditing Services is a boutique consulting firm specializing in Health Information Management (HIM) and Clinical Services for healthcare organizations across the U.S.  We pride ourselves in providing high-quality services that are tailored to our clients’ specific needs, while creating joyful experiences along the way by treating everyone with respect and care.

We are currently looking for an experienced ProFee Behavioral Health – Audit Team Lead.

• This is a remote contract position.
• Must work a minimum of 40 hours per week.
• Hours: Flexible work hours between 6:00am – 6:00pm EST

Must be authorized to work lawfully in the United States and reside within the United States.

Job Description

As a ProFee Behavioral Health Team Lead you will be assisting STAR with managing the day-to-day operations for one of our Behavioral Health Clients. You will be responsible for managing the auditing team assigned to this client including performing Quality Assurance audits, providing feedback and guidance, attending multiple client meetings, answering question, training and auditing when needed. Must have strong auditing skills with experience in Behavioral Health in the outpatient setting. We will train on client specifics however you are expected to have a thorough understanding of general auditing principles and procedures including Behavioral Health coding guidelines. Experience with EMR’s required, experience with Palentir and Foundry preferred. Must have strong attention to detail with 97% or higher quality maintained. Coding assessments are required to be considered for this position.

Responsibilities

• Manage day-to-day operations for client
• Perform Quality Assurance audits on auditors assigned to client
• Provide clear and thorough feedback and guidance on audits or questions from both auditors and client in a timely manner
• Train new auditors as needed
• Attend multiple client meetings and maintain minutes of meetings
• Audit when coverage is needed
• Reviews medical records to identify diagnoses, CPT procedures and modifiers relative to the patient’s encounter.

• Abstracts appropriate information from the medical record based on the guidelines provided by the client and after a thorough review of the medical record.

• Solicits clarification from the physician regarding ambiguous or conflicting documentation in the medical record using guidelines provided by the client.

• Ensure all coding complies with the ethical coding standards/guidelines and regulatory requirements.
• Maintains strictest confidentiality; adheres to all Health Insurance Portability and Accountability Act guidelines/regulations

Experience / Qualifications

• Must have one of the following AHIMA/AAPC certifications: CPC, CCS, RHIA, RHIT
• Extensive knowledge of medical terminology, anatomy and coding guidelines for ICD-10, CPT, HCPCS and E/M codes
• At least 3 years of recent active auditing experience in ProFee Behavioral Health Auditing
• Prefer prior Team Lead or Management experience
• Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures, and documentation including CMS guidelines
• Maintains strictest confidentiality; adheres to all Health Insurance Portability and Accountability Act guidelines/regulations
• Proficient computer skills using MS-Word, Excel, Outlook and Internet Explorer, electronic medical records (EMR) systems including Palentir and Foundry along with computer assisted coding programs.
• Meet required client productivity standards and maintain minimum of 97% accuracy
• Self-sufficient with strong analytical and research skills
• Responsible and responsive
• Strong attention to details
• Excellent written and oral communication skills
• Ability to meet deadlines
• Must reside and be legal to work in the U.S.
• Must be fully vaccinated against COVID-19 or can claim exemption based on medical reasons or religious beliefs

Technology Requirements

• Knowledge of Microsoft Office software products (Excel, Word, PowerPoint).
• Knowledge of the English language (including structure, content, spelling, rules of composition, and grammar) Excellent written and verbal communication skills.
• Must display excellent interpersonal skills.
• Excellent organizational skills for initiation and maintenance of efficient workflow.
• Must be able to work in a virtual setting independently, under minimal supervision.
• Must have reliable high-speed internet service.

STAR Medical Auditing Services LLC is an Equal Employment Opportunity / Affirmative Action employer and committed to creating a diverse environment.  All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.

https://www.starauditing.com/join-star