Senior Coding Auditor, Itemized Bill Reviewer

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

📋 Description

• Conduct detailed reviews of itemized bills, charts, and coding accuracy.

• Ensure that the itemized bill entries correctly represent the services and procedures carried out.

• Validate that services fall under covered benefits, are correctly ordered, well-documented, and reimbursed in line with plan policies and provider contract stipulations.

• Assess documentation for correct coding, billing, and reimbursement related to both inpatient hospital and outpatient facility services.

• Utilize proprietary auditing tools to record audit findings and provide justifications.

• Achieve productivity and quality benchmarks set by management.

• Obtain cross-training to conduct reviews across various claim types.

• Support management in training new Coding Auditors through daily oversight, mentoring, constructive feedback, and education.

• Stay updated on current coding guidelines.

• Participate in training sessions and scheduled meetings to improve knowledge of clinical policies, procedures, rules, and regulations.

⛳️ Requirements

• Possession of one or more active professional credentials from AHIMA or AAPC: CPC, COC, CCS, RHIA, or RHIT; mandatory.

• A minimum of 2 years of experience in inpatient hospital bill auditing and outpatient facility coding, including charge master review; highly preferred.

• Expertise in medical record auditing and familiarity with ICD-10-CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding practices.

• Solid understanding of hospital billing and charging processes, including UB-04s, itemized bills, revenue codes, CPT/HCPCS codes, and ICD-10 diagnosis and procedure codes.

• Competence in Microsoft Windows, Outlook, Excel, Word, PowerPoint, internet browsers, Microsoft Teams, Zoom, and other virtual meeting applications.

• Willingness to attend training sessions and scheduled meetings.

• Capability to fulfill required CEUs to maintain coding certification.

🏝️ Benefits

• Benefits start on your first day of employment.

• Clear opportunities for career advancement with continuous training and leadership development.

• Fully remote position.

• Flexible vacation policy.

• 401(k) with employer matching.

• Extensive health benefits.

• Educational support.

• Leadership and technical development academies.

• Potential for up to 10% travel.