Physician Enterprise Auditor
at Adventist Health System

Date Posted: 4/2/2017

Job Description



Job:  Other Non-Clinical Professional

Organization:  Adventist Health System Corporate Office

Shift:  Day

Job Posting:  Jan 11, 2017, 4:49:02 PM

If you want to be a part of a place that provides nothing less than extraordinary compassionate care, then Adventist Health System is the place for you!
We are currently seeking qualified candidates for an Auditor position that will be based in our Physician Enterprise department. This position is virtual.
This position provides the opportunity to be responsible for reviewing medical record documentation making sure that the CPT, ICD-10 and HCPCS codes and modifiers are correct for the selected claims.  The Auditor will follow AHS policy and procedure for annual audit schedules for both physicians and practices. The Auditor is responsible for completing professional reports of their findings and delivering those results to physicians and leadership.
Specific job duties include:
  • Interprets and reviews medical record documentation to make sure the accurate ICD-10, CPT, HCPCS and assigned based on provider documentation.
  • Expertise in auditing using both the 1995 and 1997 E/M CMS Guidelines
  • Provides education to providers, practice staff, and coders as needed based on audit results.
  • Demonstrates knowledge of sequencing diagnoses and procedures as outlined in the Official Coding Guidelines, CPT, HCPCS Level II and CMS guidelines.
  • Demonstrate expert job knowledge and applies current coding and billing regulations, policies, processes, and procedures with effective decision-making and problem solving skills.
  • Maintains an accuracy rate of 90% or above for all work Quality Assurance reviews.
  • Complete assigned work in a timely manner and maintain departmental production standards.
  • Maintain open communication with Auditing Team and Auditing Supervisor.
  • Critical thinking and problem solving skills are essential along with the ability to work independently, remotely and with minimal supervision. Must be self-motivated and able to use electronic resources.
Experience Requirements:
  • 3 or more years of experience in physician based coding for both E&M (outpatient/inpatient) and surgical procedures.
  • At least one year of certified auditing experience.
Educational Requirements:
  • High School Diploma or equivalent required.
  • Technical program certification in medical coding or Associate’s Degree in Medical Billing/Coding preferred.
Knowledge and Skills Required:
  • Current knowledge of E&M and surgical coding.
  • Ability to explain required documentation needs to physicians, staff, and coding staff via EMR system.
  • Experience presenting to large groups of peers or physicians/providers.
Licensure, Certification Or Registration Required:
  • Certified Professional Coder (CPC) or Certified Coding Specialist – Physician (CCS-P)
  • Certified Professional Medical Auditor (CPMA)
If this position sounds like a great match for your skills set and experience, please apply online now!

Job Snapshot

About Us

About Adventist Health System

Who We Are

We are one of the largest faith-based health care providers in the United States. For 150 years, we have carried on a tradition of providing whole-person care that not only addresses patients' physical ailments, but also supports their emotional and spiritual well-being. We demonstrate the same level of compassion and care for our employees as well, doing all that we can to help them realize their full potential – both personally and professionally.

Who You Are

You are a compassionate, talented professional who wants to work in an environment where you can live out your faith and your values. You are excited about being part of a team that uses the latest technology and medical research to ensure patients receive quality care, but who also recognize that great care is always personal. You enjoy going out of your way to make each patient and their family feel special, and are passionate about guiding them toward optimal health.

Our Community

Our community is global and so is our reach. From coordinating medical mission trips in Ethiopia to planting school gardens in Florida, we are constantly seeking ways to go beyond hospital walls in improving the health of our communities. As a member of our team, you will be encouraged to use your talents in fun, meaningful ways that bring joy and healing to people around the world.

Our Mission

Part of this worldwide network, Adventist Health System was founded in 1973 to support and strengthen the Seventh-day Adventist health care organizations in the Southern and Southwestern regions of the United States. Today it is a national leader in quality, safety and patient satisfaction, comprised of 46 hospital campuses and nearly 77,000 employees.

Although separated by geography, each of our facilities is united by the mission of Extending the Healing Ministry of Christ. Today we continue the tradition of whole-person care by practicing and sharing CREATION Health, a blueprint for living a healthy, happy life based on the principles given in the Bible’s creation story: Choice, Rest, Environment, Activity, Trust, Interpersonal relationships, Outlook and Nutrition.

We provide comprehensive benefits, training and advancement opportunities. We care for our employees as well as we care for our patients.