Coding Compliance Auditor

4 weeks ago


Jacksonville, United States CareSpot Urgent Care Full time
Job DescriptionJob Description

Position Summary
The Coding Compliance Auditor is required to be dependable and accurate. The Coding Compliance Auditor is responsible for supporting ongoing coding compliance at CareSpot Urgent Care Assigned responsibilities must be managed and completed within defined deadlines.

Duties and Responsibilities

  • Communicating with both internal and external customers regarding any coding and billing issues while practicing CareSpot’s values
  • Responsible for the monthly coding audits based upon agreed number of claims per CareSpot clinic for coding accuracy, based on medical record documentation
  • Completion of ad hoc coding audits as assigned by the Director, Compliance
  • Support with the development and execution of annual Compliance Work Plans
  • Review adjudicated claims for posting accuracy
  • Train new staff on billing procedures and coding guidelines with the assistance of the department leaders
  • Establish corrective and proactive training actions for existing clinical and billing staff
  • Responsible for a range of special projects including medical record audits or actions by third parties
  • Communicate and coordinate any issues with the Director, Compliance
  • Any other responsibilities assigned by the Director, Compliance

Experience, Skills and Education

Education:

High School diploma or equivalent. Have a thorough understanding of the medical billing process, coding guidelines and auditing process.

Required Certification:

Professional Coding Certification (CPC, CPMA and/or CCS-P)



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