Regulatory Services Auditor

Job Title: Regulatory Services Auditor

FLSA Status:  Non-Exempt

About us

Physicians East, P.A.is a team of skilled healthcare professionals united to meet the challenge of delivering quality, cost-efficient, comprehensive healthcare to the people of Eastern North Carolina.

About the role

We are looking for an employee that can work in a fast-paced multispecialty physician group to conduct in-house audits, provider education, and provide coding related support to ensure coding accuracy and compliance. Predominantly remote position with periodic travel to Physician’s East locations to deliver audit findings and conduct provider education.   Combined training approach to consist of virtual meetings and in person sessions.  Candidate must be located in North Carolina.

Supervision Received: Reports to Regulatory Services Supervisor.

Supervision Exercised: Limited.

Typical Physical Demands: Requires prolonged standing or sitting while working in an work environment.  Requires some bending or stretching.  Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, and other office equipment.

Typical Working Conditions:

Hybrid – Remote with 30% travel.

Responsibilities

Conducts provider and coder audits to ensure coding levels and charting meets standards and regulations

Educates providers and team members on compliance audit findings or when problems are identified

Develops ongoing educational content to present to coding department and providers

Responsible for being up-to-date and knowledgeable of coding process and diagnostic procedures as well as carrier specific policies, guidelines, and updates 

Shares information as necessary with the Coding & Insurance department

Provides training and serves as a general resource to assist coders and members of department staff

Provides information to providers and team members on current coding practices and changes in regulations and guidelines

Collaborates with team leadership to address coding trends

Utilizes coding resources or applicable reference materials to ensure accurate coding

Understand billing and coding requirements for government and commercial payers

Provide other assistance to the Coding or Insurance Department as directed by the Regulatory Services Leadership 

Maintains patient confidentiality

May serve as a backup for coding in times of peak workload

Assist with special projects as assigned by leadership

Ability to work independently and proficiently in a remote office environment

Attends meetings when required (onsite/remote)

Location & commitments

Permanent full-time role based out of our Greenville Arlington Blvd. location, Monday-Friday, 8a.m. – 5 p.m.

Candidate will work remotely upon training with 30% travel required.

Flexible schedule.

Candidate must be located in North Carolina.

Candidate requirements

Associates degree or Bachelors degree in Health Information Management with RHIT/RHIA certification and 3-5 years of multi-specialty ICD-10 and CPT experience, or 

Bachelor’s degree in health care related field with CPC/CCS-P/CPMA certification and 2-4 years of direct ICD-10 and CPT experience, or 

CPC/CCS-P/CPMA certification with 4-6 years of multi-specialty ICD-10 and CPT experience. 

Affirmative Action/EEO statement

Physicians East, P.A.is an equal opportunity employer and will not discriminate against any applicant or employee on the basis of age, race, color, ethnicity, religion, creed, sex (including gender, pregnancy, sexual orientation, and gender identity, which includes status as a transgender individual), national origin or ancestry, citizenship, past, current, or prospective service in the uniformed services, genetic information (including family medical history), physical or mental disability, or other legally protected status. Reasonable accommodation will be made for persons with disabilities during the application process and/or at the time of employment. Requests for accommodation should be made to the Human Resources Department as early as possible in the application/employment process. Contact HR Office at 252-413-6368 or email careers@physicianseast.com

Disclaimer

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Signatures

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