Coding Auditor Specialist

5 days ago


Arlington, Virginia, United States Med-Metrix Full time
Job Title: Coding Auditor

Med-Metrix is seeking a skilled Coding Auditor to join our team. As a Coding Auditor, you will be responsible for ensuring the accuracy and compliance of medical coding and documentation in a multi-specialty setting.

Key Responsibilities:
  • Perform coding audits and compliance audits for providers, including physicians and mid-level providers, to ensure accurate and compliant coding practices.
  • Prepare and present audit results to internal and external parties, providing education and guidance on coding and documentation best practices.
  • Apply coding and documentation guidelines, including E&M and surgery documentation guidelines, CCI guidelines, CPT/HCPCS coding guidelines, and specialty association guidance.
  • Provide physician education on audit findings, edit and denial trending, and other coding-related topics.
  • Work with offsite auditors to ensure seamless auditing processes.
  • Evaluate and report on the overall quality of physician documentation that supports selected codes, including medical necessity.
  • Adhere to local and national coverage determinations, and CCI and payer-specific editing rules.
  • Ensure accurate documentation and coding of split/shared services, teaching physician guidelines, and client-specific quality assessment programs.
  • Compile, trend, analyze, and report on all findings that do not meet coding and documentation guidelines.
Requirements:
  • High School diploma or equivalent required.
  • CPC or CCS coding certification required from AHIMA or AAPC.
  • Minimum 5 years of coding experience and minimum 2 years auditing experience in a multi-specialty setting.
  • Knowledge of Microsoft Word, Outlook, Excel, and job-related software.
  • Self-starter with ability to work independently.
Working Conditions:
  • Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; sit; perform manual tasks; operate tools and other office equipment.
  • Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
  • Work Environment: The noise level in the work environment is usually minimal.

Med-Metrix is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive work environment that values diversity, equity, and inclusion.



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