Coding Auditor-2 positions-FT-Provo
1 month ago
At Revere Health, we believe there is a better path to healing and healthcare maintenance, and we’re working on this mission—one patient at a time. We’re a national leader in a movement called value-base care which aims to improve treatment outcomes and keep costs down. Our internal culture is one that promotes respect and consistently recognizes the impact that individual employees have on the mission of the organization.
Position Summary: We are looking for a detail-oriented Coding Auditor to ensure the accuracy and compliance of our coding processes. The Coding Auditor will be responsible for reviewing, analyzing, and auditing medical codes to identify discrepancies, errors, and potential areas for improvement. This role requires a understanding of coding guidelines, regulations, and best practices, as well as strong analytical skills and attention to detail.
Essential Job Functions: Conduct regular audits of medical coding practices to ensure accuracy, completeness, and compliance with regulatory requirements. Review medical records, claims, and billing documents to verify the appropriateness and accuracy of assigned codes. Identify and investigate coding errors, discrepancies, and potential fraud or abuse. Collaborate with coding staff, healthcare providers, and other relevant stakeholders to address coding issues and implement corrective actions. Develop and maintain audit protocols, tools, and documentation to support the auditing process. Stay informed about changes in coding regulations, guidelines, and industry best practices. Provide training and education to coding staff and other team members on coding standards, compliance requirements, and audit findings. Generate reports and analysis of audit findings, trends, and areas for improvement.
Qualifications: Minimum of 5 years of coding experience. Certified Coding Specialist Must receive Coding Audit Certification within one year of hire. Thorough knowledge of ICD-10, CPT, HCPCS, and other medical coding systems and guidelines. Familiarity with healthcare regulations, compliance requirements, and coding standards (e.g., HIPAA, HITECH, OIG). Strong analytical skills and attention to detail. Excellent communication, interpersonal, and problem-solving abilities. Ability to work independently and collaboratively in a fast-paced environment. Proficiency in coding software and electronic health record (EHR) systems. Experience with auditing tools and methodologies is a plus.
Hours: Monday - Friday 8am to 5pm This position offers a hybrid work-from-home arrangement, allowing eligible candidates to work remotely part of the time. To be considered for remote work privileges, candidates must meet specific performance criteria and demonstrate the ability to effectively manage their responsibilities from a remote location.
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