Professional Billing Coding Auditor

What you need to know about this position: Responsible for evaluating and auditing provider coding and documentation compliance to determine appropriate code assignments for diagnoses and services performed (HCPCS/CPT codes). Develops quality audit reports that identify trends and educational opportunities. Responsible for training and educating providers, clinical staff, and departments, one-on-one and in a group setting, on all aspects of coding and documentation utilizing both oral and written direction. Prepares training and presentations on applicable topics. Serves as a resource for information or clarification on accurate and ethical coding and documentation standards, guidelines, and regulatory requirements and new coding initiatives. Proactively identifies areas of opportunity to improve coding quality based on audit feedback, coder questions, physician escalations, denial meetings, and other platforms and plans provider education accordingly. Assists in the formulation and review of policies and guidelines affecting the coding of professional services. Requires strong organizational skills and the ability to meet deadlines independently. Requires the ability to professionally interact with physicians and mid-level providers with strong skill in verbal and written communications and customer relations. Accurately applies ICD-9-CM, ICD10 CM and CPT-4 classification systems, utilizing Optum. Assists Manager with monitoring, coordinating and responding to external audits and questions. The hourly range for this position is between $26.65 and $40.00. Individual compensation is determined for this position through years of directly relevant experience. The hourly compensation is only a portion of the total rewards package and a comprehensive benefits program is available for qualifying positions. In this position you will be required to work full-time, 8:00AM-5:00PM, Monday through Friday. This position is partial remote eligible. What is required for this position: Education and/or Experience A minimum of 5 years of coding and audit experience required. 7 years of coding and/or audit experience with additional experience performing training and providing feedback to coding and physician audiences preferred. Previous experience in management, quality improvement, compliance, auditing and revenue cycle related activities preferred. Bachelor's degree in Health Information Management or other healthcare related degree preferred. A score of 90% or higher on the Coding Assessment Tool is required. Certifications, Licenses, Registrations One of the following is required: Certified Coding Specialist (CCS) Certified Coding Specialist - Physician Based (CCS-P) Certified Outpatient Coder (COC) Certified Professional Coder (CPC) Certified Inpatient Coder (CIC) Registered Health Information Administrator (RHIA) Registered Health Information Technician (RHIT) Certified Professional Medical Auditor (CPMA) or Certified Documentation Improvement Practitioner (CDIP) certification preferred.

Created: 2024-10-19