Coding Auditor

This is a fully remote position, open to applicants in Connecticut, +2 more states.

📋 Description

• Review data, claim submissions, and member medical records for thoroughness, accuracy, and adherence to Healthfirst policy.

• Document audit results in accordance with departmental protocols.

• Detect trends of underperformance, noncompliance, and discrepancies, and propose solutions.

• Assess the quality of medical coding and inform management of any discrepancies.

• Carry out internal audits of medical record evaluations conducted by team members.

• Work collaboratively with various departments to enhance compliance with coding standards and clinical practice guidelines.

• Contribute to ongoing improvement and quality initiatives across departments.

• Execute additional responsibilities as required.

⛳️ Requirements

• Coding certification from the American Academy of Professional Coders (AAPC), Certified Professional Coders (CPC), or the American Health Information Management Association (AHIMA).

• High school diploma or GED.

• Relevant prior experience.

• Skills in time management, critical/creative thinking, communication, and problem-solving.

• Capability to handle large caseloads and work efficiently in a fast-paced setting.

• Proficient writing, electronic documentation, and assessment skills.

• Intermediate skills in Outlook and basic skills in Word, Excel, PowerPoint, and Adobe Acrobat.

• Familiarity with ICD10 and medical terminology related to anatomy and pathophysiology.

🏝️ Benefits

• Coverage for medical, dental, and vision.

• Incentive and recognition programs.

• Life insurance.

• Contributions to a 401k plan.

• Competitive salary and benefits package.