QA Coding Auditor

2 days ago


Dallas, United States Robert Half Full time
Job DescriptionJob DescriptionWe are seeking a QA Coding Auditor to join our healthcare team in Dallas, Texas. This role focuses on auditing medical coder's accounts to ensure accuracy and compliance, as well as validating the judgements of coding auditors. This role is vital for correct billing, optimal reimbursement, and minimizing the risk of audits and penalties from regulatory bodies.

Responsibilities
• Conduct comprehensive reviews and validation of coding auditor's recommendations, scrutinizing the appropriateness of diagnostic and procedural codes assigned by the medical coders based on the auditors' feedback.
• Perform quality assurance checks on accounts where the coding auditor has made no recommendations, auditing these accounts independently to confirm the original coding accuracy.
• Work closely with project managers, providing feedback on review findings including addressing any discrepancies or errors found during the review process, clarifying coding rules and guidelines along with hospital internal coding policies, and sharing information on how to improve coding accuracy and compliance.
• Stay up-to-date with changes in internal coding policies, coding standards, healthcare regulations, and compliance requirements.
• Ensure that both the coding auditors' recommendations and their decisions to make no recommendations are accurate, contributing to the smooth and efficient operation of the organization's quarterly coding audits process.

• Proficiency in Audit Engagements

• Ability to develop and manage Audit Plans

• Must possess a Coding Certificate

• Expertise in Audit and Information Systems Audit

• Proven ability to Perform Quality Assurance

• Knowledge of QA - Quality Assurance

• Experience in Quality Assurance

• Familiarity with Epic Hospital Billing

• Experience with Epic EMR software

• Proficiency in using MEDITECH

• Understanding of Health policy applicable in a healthcare setting



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