Coding Auditor

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct audits on provider documentation and assigned CPT and ICD-10 codes.

• Assess whether clinical documentation substantiates the diagnoses and procedures billed.

• Detect coding errors, documentation shortcomings, charge-capture concerns, and areas for enhancement.

• Review coding outputs from professional coders, healthcare providers, and other medical personnel.

• Offer constructive and educational feedback to providers and coders.

• Provide education on coding requirements, documentation standards, and updates on regulations.

• Remain informed about CMS, state, and payer coding regulations and requirements.

• Collaborate with the Coding Supervisor and Regional Medical Directors to enhance documentation and coding precision.

• Perform charge entry and Charge Review tasks as necessary.

• Identify coding trends such as undercoding and suggest corrective measures.

• Assist in error correction and initiatives for process improvement.

• Achieve set daily production and quality benchmarks.

⛳️ Requirements

• Current CPC or CCS coding certification from AAPC or AHIMA.

• Relevant experience in professional coding and/or coding auditing.

• Over 2 years of experience in medical billing.

• Experience in Urgent Care or Occupational Health billing.

• Familiarity with insurance payers, accounts receivable, revenue cycle processes, and denied claims.

• Proficient in billing software and electronic medical records.

• High school diploma or equivalent qualification.

• Strong grasp of medical coding and documentation requirements.

• Exceptional critical-thinking and analytical abilities.

• Capability to differentiate between a coding mistake and a documentation shortfall.

• High attention to detail and a strong commitment to accuracy.

• Ability to convey audit findings in a clear and constructive manner.

• Comfortable in providing corrective feedback and educating providers and coders.

• Strong organizational abilities and capacity to manage a high-volume workload.

• Skill in identifying coding trends and formulating practical solutions.

• Commitment to staying updated with coding changes and regulatory requirements.

• Positive and collaborative mindset with the ability to work effectively in a fast-paced setting.

🏝️ Benefits

• Full-time remote work opportunity.

• Chance to engage in meaningful work within a supportive and expanding organization.

• Opportunities to educate providers and coding teams while contributing to their professional growth.