Professional Billing Coding Auditor

4 weeks ago


Columbus, Ohio, United States Columbus Regional Health Full time
Coding Compliance Specialist

This position is responsible for evaluating and auditing provider coding and documentation compliance to determine appropriate code assignments for diagnoses and services performed (HCPCS/CPT codes).

Key Responsibilities:
  • Evaluate and audit provider coding and documentation compliance
  • Determine appropriate code assignments for diagnoses and services performed
  • Develop quality audit reports that identify trends and educational opportunities
  • Train and educate providers, clinical staff, and departments on coding and documentation
  • Prepare training and presentations on applicable topics
  • Serve as a resource for information or clarification on accurate and ethical coding and documentation standards, guidelines, and regulatory requirements
  • Proactively identify areas of opportunity to improve coding quality
  • Assist in the formulation and review of policies and guidelines affecting the coding of professional services


Requirements:
  • Minimum of 5 years of coding and audit experience
  • 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:
  • 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


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