Coding Auditor - Physician Business Coding - Days - FT

Job Description

The Coding Auditor will perform coding quality audits of outpatient/ambulatory records to assure appropriateness and accurate code assignments. The auditor will ensure records are billed accurately, consistent with medical record documentation and in compliance with federal and state regulations.

Responsibilities

• Responsible for conducting internal audits of the medical documentation, coding, and billing to ensure compliance with regulations and payer policies
  • Performs internal audits of medical documentation supporting claims billed to third parties to ensure accordance with regulations
  • Evaluates the appropriateness of the services and procedures, diagnoses, and service levels billed based on the supporting documentation and in accordance with coding guidelines
  • Coordinates and reconciles RVU/charge posting reports
  • Prepares and distributes audit result reports
  • Provides support to ongoing projects with other departments to resolve billing and documentation issues
• Provide formal and informal coding and regulatory education
  • Create educational materials to be used during educational sessions
  • Assists in the development of educational programs for providers based on audit finding(s), as well as general education on coding and documentation rules and regulations
  • Provides support to medical providers and Medical Coders regarding coding compliance documentation, regulatory provisions, and third-party requirements

Qualifications

Education:

• Associate's Degree in Health Information Management, Medical Coding, Business or related field. Certification in CPC and must obtain CPMA certification within one (1) year of hire.

Experience:

• Four (4) years experience as a medical coder with ICD-10 experience

Skills:

• Analyzing and organizing technical data
• Multitasking, time-management, and organization
• Verbal and written communication