Professional Billing Coding Auditor
4 weeks ago
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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