Compliance Auditor

Gill Compliance Solutions (GCS) is growing, and we're looking for an experienced

Cardiology Coding Auditorto join our nationally recognized consulting team in apart-time, remote position.

Our consultants work directly with physician practices, hospitals, health systems, emerging healthcare technology companies, and legal firms across the country to improve documentation, coding accuracy, compliance, and reimbursement. Every day presents new challenges and opportunities to make a measurable impact.

If you enjoy auditing complex cardiology services, identifying coding and reimbursement opportunities, educating providers, and solving challenging coding issues, we'd love to meet you.

• Perform cardiology coding and documentation audits to ensure accuracy of CPT, HCPCS, ICD-10 codes, and modifiers in accordance with federal, state, Medicare, and payor guidelines.
• Audit cardiology services including E/M, diagnostic cardiology, cardiac catheterization, interventional cardiology, electrophysiology, device procedures, echocardiography, stress testing, and other cardiovascular services. Some of this might include some surgical cardiothoracic cases.
• Review medical record documentation for coding accuracy, medical necessity, diagnosis specificity, appropriate modifiers, and missed coding or reimbursement opportunities.
• Identify documentation and coding trends and prepare practical education for physicians, APPs, coders, and other clinical staff.
• Research and client questions involving coding, denials, rejected claims, Medicare requirements, NCCI edits, and payor policies.
• Navigate Epic, Cerner, Allscripts, and other commonly used EHR systems to conduct audits.
• Effectively manage assigned work and audit projects using systems such as Smartsheet and Box.
• Remain current with CPT, HCPCS, ICD-10-CM, CMS, Medicare, and commercial payor coding and reimbursement requirements.

We're looking for someone who has:

• CPC, CCS, CCS-P, or equivalent coding certification required.
  
  Cardiology-specific certification is strongly preferred.
• Four or more years of physician coding/auditing experience, with cardiology experience. Strong knowledge of cardiology coding, including diagnostic and interventional cardiovascular services.
• Strong ICD-10-CM coding skills, including cardiovascular diagnosis coding, specificity, sequencing, and medical necessity.
• Strong knowledge of E/M coding, modifiers, NCCI edits, global surgery rules, and professional versus technical component billing.
• Experience with cardiac catheterization, coronary interventions, electrophysiology, pacemakers/ICDs, echocardiography, stress testing, and other cardiovascular procedures.
• Strong CMS and Medicare regulatory knowledge.
  
  Noridian experience is highly valued.
• Experience educating physicians, clinical staff, and coders.
• Excellent analytical, presentation, communication, and professional writing skills.
• Ability to independently research complex coding and reimbursement questions.
• A passion for helping healthcare organizations improve compliance, documentation, coding accuracy, and reimbursement.

• Part-time, remote
• Flexible schedule
• Paid CEUs
• Compensation DOE
• Opportunity for additional projects based on client needs

Excellent professional references are required.