What are the responsibilities and job description for the Regulatory Services Auditor position at Physicians East?
Job Description
Job Description
Job Title : Regulatory Services Auditor
FLSA Status : Non-Exempt
We are looking for an exceptional Regulatory Services Auditor to join our practice!
Physicians East, PA is a multi-specialty, multi-campus group based out of Greenville, NC offering a wide range of specialties. In addition to primary care the practice offers pulmonary and critical care medicine, rheumatology, dermatology, oncology, endocrinology, cardiology, obstetrics and gynecology, gastroenterology, surgery, urology, and urgent care. Our 102 providers and over 600 employees provide services for thousands of patients in a 29-county region. Our specialists are on staff at ECU Health, a 900 bed, level one trauma center and the primary teaching hospital for the East Carolina University Brody School of Medicine (ECU-BSOM).
Located in the coastal plain area, only one hour from the Atlantic Ocean, Greenille is the vital center of business, industry, culture, education, and health care for eastern North Carolina. Its incomparable quality of life, the hospitality of its people, its modern outlook and interstate accessibility has contributed to the city's rapid growth. It has become a premier location to raise a family and enjoy a high quality of life. The mild climate and access to rivers and the ocean allows its residents to enjoy water sports, golf, tennis, and other sports, outside year-round.
Some of the benefits you will enjoy at Physicians East!
Comprehensive Medical and Prescription Drug Plan
Reduced co-pays for those that utilize Physicians East Medical Providers!
Convenient onsite employee pharmacy that offers reduced co-pays!
Dental insurance
Vision insurance
Critical illness, and other supplemental insurance plans available with payroll deduction!
Employee assistance program at no cost to employee and covered dependents!
Competitive long-term and short-term disability plans!
Life insurance provided at no cost to the employee with options to purchase additional protection for you and your family!
401(k) with generous company matching contributions!
Profit Sharing Program!
Flex Spending Account
Company Paid Short Term Disability Insurance
Company Paid Long Term Disability Insurance
Generous PTO program to provide our employees with essential work / life balance!
Paid holidays in addition to accrued PTO!
Convenient parking onsite and close to where you work!
Employee Discounts Programs to save you money
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
This job description has been approved by :
Manager_____________________________________ Date ____________
HR__________________________________________ Date _________________
Employee signature below indicates the employee's understanding of the requirements, essential functions, and duties of the position.
Employee______________________________________ Date__________________
