Coding Compliance Auditor

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

📋 Description

• Conducts thorough audits of hospital Inpatient, Ambulatory Surgery, Observation, and other outpatient visits to ensure appropriate reimbursement, research, and adherence to federal and state regulations by following established ICD-10-CM/PCS coding and/or CPT-4 procedure coding systems.

• Acts as a clinical coding subject matter expert, employing critical thinking to analyze and assess documentation issues in consultation with medical and clinical staff, as well as clinical documentation specialists when necessary.

• Reviews ICD-10 diagnostic codes and CPT-4 procedure codes for outpatient, ambulatory surgery, and observation visits to support reimbursement, research, and compliance with federal and state regulations.

• Evaluates complex inpatient cases, including trauma, rehabilitation, neurology, and critical care, using ICD-10-CM and ICD-10-PCS nomenclature to ensure precise APR-DRG/SOI/ROM and POA assignments.

• Functions in an advisory and educational capacity for Coding Specialists.

• Engages with various departments within the hospitals to discuss coding accuracy.

• Adheres to AHIMA standards of ethical coding and coding compliance guidelines.

⛳️ Requirements

• High School diploma or equivalent.

• Formal training in ICD-10-CM, ICD-10-PCS, and CPT-4 coding.

• Associate's or Bachelor's degree.

• A minimum of two years of experience in ICD-10-CM/ICD-10-PCS coding and abstracting within a Level 1 Trauma hospital, or four years of coding inpatient hospital medical records.

• 2-3 years of experience in ambulatory coding.

• Must possess experience in inpatient auditing.

• One of the following credentials: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Inpatient Coder (CIC).

🏝️ Benefits

• Flexible work arrangements.

• Temp to hire.