External Auditor Physician

Under general supervision of client, Omega’s External Auditor Physician will perform reviews of inpatient and outpatient or Professional Services medical records for coding accuracy and medical record documentation as it impacts the accuracy of ICD-10-CM, ICD-10-PCS codes driving MS-DRG assignment and ICD-10-CM and CPT-4/HCPCS codes driving the APC assignment.

The External Auditor Physician must be able to identify Physician query opportunities, write compliant queries, assess the accuracy of POA, discharge disposition and modifier assignments. External Auditor Physician performs data collection for quality and statistical purposes and reports the findings to Omega’s clients.

Review inpatient,outpatient,orphysicianservicesmedicalrecordsforaccuracyofcodinganddataquality. Elements to be included in reviews can include:

AlldiagnosisandprocedureassignedICD-10-CMandICD-10

PCS codes

AlldiagnosisandprocedureassignedICD-10-CMandICD-10

PCS codes

AllCPTassigned codes

APC assignment Professional Services

AllCPT codes

AllE&MLeveling codes

Maintainauditingproductivitybasedon Clientand Omegaagreedupon  requirements

Utilize all available official references to perform reviews: to include but not limited to International Classification of Diseases,9 th Edition,Clinical Modification(ICD-9-CM),the Current Procedural Terminology  (CPT-4) Official Coding Guidelines, Coding Clinic, CPT Assistant, CMS guidelines, etc.

• Demonstratestrongorganizationalskillsandbedetail oriented.
• Demonstrateabilitytoself-motivate,setgoals,andmeet deadlines.

Abilitytodevelopandmaintainrelationshipswithkeybusinesspartnersbybuildingpersonalcredibilityand trust.

Maintainscourteousandprofessionalworkingrelationshipswithemployeesatalllevelsofthe organization.

• Demonstrateexcellentanalytical,criticalthinkingandproblem-solving skills.
• Abilitytoidentifydeficienciesandtakecorrective action.

Thephysicaldemandsdescribedherearerepresentativeofthosethatmustbemetbyanemployeeto successfully perform the essential functions of this job.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger,handle,orfeelobjects,tools,or controls;reachwithhandsandarms;climb stairs;balance;stoop,kneel, crouchorcrawl;andtalkorhear.

Theemployeemustoccasionallyliftormoveupto
25pounds.

Specificvision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.

This is a full-time position.

Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m. This position occasionally requires long hours and weekend work.

Musthaveatleasttwoyearsof HIM experience,preferablyasan Auditor.

Atleastoneyearofauditing experience.

Minimumofsuccessfulcompletionofan AHIMA approved

Coding

Certificate Program.

None.

CCS, CPC, CPC-P, CPC-H, RHIA or RHIT

In addition to the specific security access required by the employee’s client engagement, the employee will have access to the Omega systems set forth in the “Standard Field Employee” profile.

Microsoft Office

ADP

Oracle

E1
- All Field Employees

Standard Employee

Standard

Coder and Client Access based on client needs. Determined by manager and granted by Audit Implementation Manager

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.

Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at…