Title of Position: Coding Auditor

Position Summary:

The Coding Auditor will be responsible for auditing process and compliance with all applicable federal, state and local regulations and guidelines.

Responsibilities:

• Auditing 10 percent of medical records/ EHR documentation to identify under-coded and up-coded services, incorrectly billed procedures, etc.
• Validates ICD-10-CM, HCPCS and CPT-4 codes (includes E/M) and modifiers for all medical records within quality standards set by the department and supported by medical record documentation.
• Ensures correct coding of services are provided and are according to regulatory (e.g. NCCI), coding (AMA CPT descriptions, etc.) and billing guidelines.
• Monitors coding and abstracting quality by conducting and/or coordinating ongoing audits to ensure coding quality and performance improvement standards are maintained, achieved and improved.
• May assist in preparing reports of findings and assist with education and training documents on accurate coding practices and compliance issues.
• Keeps knowledge of coding requirements and related skills.
• Recognizes and consistently recommends changes to processes, documentation guidelines etc., once applicable.
• Provides expertise or assistance to staff and other departments when problems or questions arise regarding coding.
• Ensure compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines.
• Maintaining strictest confidentiality and adhering to all HIPAA guidelines and regulations.
• Other revenue capture project as assigned.

Qualifications:

· Strong CPT/ ICD-10 CM/ coding proficiency required.

· Certified Professional Coder (CPC) or Certified Risk adjustment Coder (CRC) desired.

· Foreign medical graduate/doctor preferred.

· Advanced knowledge of Microsoft suite (Word and Excel).

· Knowledge of basic third-party operating procedures and practices.

· Knowledge of Medicare and HMO.

· Bilingual

Job Type: Full-time

Pay: From $56,160.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person