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Nurse Practitioner Coding Auditor

1 month ago


Linthicum Heights, Maryland, United States CommuniCare Family of Companies Full time
Job Summary

The CommuniCare Family of Companies is seeking a skilled Nurse Practitioner Coding Auditor to join our team. As a key member of our coding team, you will be responsible for reviewing and assessing the accuracy, completeness, and specificity of diagnosis codes in medical records. Your expertise in ICD-10-CM coding and HCC methodologies will be essential in ensuring compliance with CMS and coding best practices.

Responsibilities
  • Review medical records to determine completion and compliance with CMS and coding best practices
  • Assess the accuracy, completeness, and specificity of diagnosis codes identified in the medical record
  • Communicate effectively with the coding leadership and clinical team regarding issues or corrections with the medical record
  • Understand the relationship between ICD-10-CM coding and HCC coding
  • Identify, correct, and report coding problems
  • Maintain adequate knowledge of coding, compliance, and reimbursement procedures related to Medicare risk adjustment
  • Make recommendations for coding policy/changes
  • Follow all legal and policy requirements for HIPAA protected data
Requirements
  • Master of Science in Nursing, Doctor of Nursing Practice, or NP Certificate Program graduate
  • National certification of AANP or ANCC
  • Active, unrestricted state license/s
  • Ability to obtain licensure in additional states in service area as requested
  • Active DEA license
  • US work authorization
  • 3+ years clinical experience as a Nurse or Nurse Practitioner in geriatric, adult, or family practice setting