Coding Auditor
6 days ago
We are seeking a skilled Coding Auditor to join our team at Sharp HealthCare. As a Coding Auditor, you will play a critical role in ensuring the accuracy and compliance of our coding practices, with a focus on risk adjustment and medical compliance.
Key Responsibilities- Provide administrative and coding support to management, site support, staff, and physician offices.
- Identify and report documentation and coding opportunities, making recommendations for improved code capture and reporting.
- Monitor and report coding trends, immediately communicating coding discrepancies to management.
- Work to improve overall provider accuracy.
- H.S. Diploma or Equivalent
- 3 Years experience working as a certified coder
- 2 Years experience working as a HCC risk adjustment coding auditor
- Experience with medical billing and medical terminology
- Certified Professional Coder (CPC) - AAPC - REQUIRED
- Act as a resource, requesting, reviewing, and coding medical services from reports and notes to convert procedural and diagnostic notes into appropriate levels of care following coding rules and regulations.
- Apply understanding of Medicare, Medi-Cal, and other payor guidelines.
- Identify documentation deficiencies and recommend methods for resolution that satisfy regulatory and SCMG compliance requirements.
- Perform medical chart audits meeting minimum department productivity standards.
- Exercise mature judgment and maintain confidentiality in all activities.
- Educate clinicians on specific coding issues based on medical records review and coding principles.
- Educate clinicians and their staff on the HCC/Risk Adjustment coding guidelines and make recommendations for documentation improvement.
- Educate clinicians on coding updates and processes.
- Serve as a key resource for documentation requirements and training on the documentation requirements needed for each HCC/RAF recorded.
- Develop and build relationships with clinicians and their staff to achieve improvements in risk adjustment documentation, data validations, as well as program participation.
- Familiarity with radiology and laboratory coding.
- Knowledge of Coding Procedures and Medical Terminology.
- Proficient on CPT, HCPCS, and diagnosis coding in an ambulatory setting.
Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class.
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