Medical Coding Auditor

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

📋 Description

• Analyze, assess, and provide insights during quality assurance activities and QA audits.

• Ensure compliance with federal, state, and payer coding standards and regulations.

• Offer feedback to global coding teams to facilitate effective coding for BOOST clients.

• Keep communication logs that document the training of global coding teams.

• Report coding trends and issues to the department lead.

• Review target cases monthly in accordance with the ModMed Quality Assurance SOP.

• Record daily audit results in the Daily Audit Log.

• Relay coding resolutions to BOOST and global coding teams.

• Assist in compiling monthly QA audit log summary pages that detail global coding accuracy levels.

• Collaborate on inquiries, clarifications, QA rebuttals, and training requests.

• Work alongside coding leadership on training related to coding processes, documentation, coding guidelines, and QA findings.

• Participate in remote coding sessions and sync or committee meetings.

• Facilitate communication between internal BOOST RCM teams and the Auditing team.

• Conduct special BOOST quality assurance audits, including assignment accuracy and coding appeals accuracy.

• Carry out BOOST or Compliance audits as needed.

• Assist in the review, appeal, and follow-up of third-party audits such as RAC and CERT.

• Help maintain coding guidelines, coding scrub edits, and practice coding instructions.

• Promote continuous quality improvement and the implementation of coding protocols and procedures.

• Collaborate with coding and auditing team members to uphold department compliance and effectiveness.

⛳️ Requirements

• Maintain coding certification(s) through continuing education units (CEU).

• Possess knowledge of ICD-10-CM, HCPCS, CPT procedural coding, modifier usage, and federal, state, and payer-specific coding guidelines.

• Ability to conduct coding reviews, quality assurance audits, denial management coding, and compliance audits.

• Capable of analyzing coding denials and providing claim corrections when necessary.

• Ability to furnish statistical and qualitative feedback to coding teams.

• Skill in collaborating with internal and global coding teams on inquiries, clarifications, QA rebuttals, and training requests.

• Competent in reviewing and maintaining coding guidelines, coding scrub edits, and practice coding instructions.

• Ability to support third-party audits, including RAC and CERT audits.

🏝️ Benefits

• Comprehensive medical, dental, and vision benefits, including a company contribution to a Health Savings Account.

• 401(k) matching contribution of 50% of employee contributions deferred on up to 6% of compensation; matching contributions fully vest after one year.

• Generous Paid Time Off.

• Paid Parental Leave programs.

• Company-paid Life and Disability benefits.

• Flexible Spending Account.

• Employee Assistance Programs.

• Company-sponsored Business Resource & Special Interest Groups.

• Opportunities for professional development.

• Tuition reimbursement programs.

• Unlimited access to LinkedIn Learning.

• Global presence with opportunities for in-person collaboration.

• Dog-friendly headquarters.

• Weekly catered breakfast and lunch.

• Treadmill workstations.

• Zen and wellness rooms.

• Remote work availability for certain roles.