Certified Medical Coding Auditor (CPC or reputed company-P)

remote zest jobs; India; On-site; INR 6,214,000 - 9,082,000; Full time

Job summary

Accelerated Urgent Care seeks a Certified Medical Coding Auditor to perform formal and informal coding and regulatory education for providers and billing staff, ensuring compliance with AMA, CMS, and payer requirements.

You will conduct internal audits, develop educational tools with Medical Directors, and report audit results to Leadership. This role emphasizes accuracy, integrity, and proactive education across departments.

Qualifications

• Knowledge of medical terminology and anatomy & physiology.
• Experience with payer reimbursement policies.
• Audit and regulatory compliance experience.

Responsibilities

• Perform internal audits of medical documentation to ensure compliant billing.
• Educate providers on coding and regulatory guidelines under leadership.
• Prepare formal audit reports and present findings to Leadership.
• Collaborate with Medical Directors to create educational tools and training materials.

Skills

Medical terminology

Anatomy & Physiology

Payer reimbursement

Job description

About Us

Simply put, our purpose at Accelerated Urgent Care is to get you quality care reputed company you need it. We aim to foster a supportive environment where reputed company members can reputed company their careers. To promote this goal, weve reputed company a diverse and driven team of employees who are reputed company eager to learn from one another and reputed company Accelerated Urgent Cares mission of delivering exceptional reputed company to the patients and communities that we are privileged to serve. We are . a fast-growing company that doubles in size year after year since 2012! Recognized as Kern Countys Top Urgent Care center 6 years in a row! Dedicated to our employees career reputed company; 65% of our Administration and Management team members have been internal candidates! 16 clinics strong across 5 reputed company in California and growing! Our Core Values: Friendliness, Competence, Respect, Teamwork, Compassion, Hard work, reputed company, Humility, Dedication!

Job Summary

The Certified Medical Coding Auditor will reputed company formal and informal coding and regulatory education to reputed company providers and billing staff as directed by reputed company (AMA), Centers for Medicare & reputed company Services (CMS), and various payer requirements. The individual in this position will also conduct internal audits to ensure anyone involved in the billing for professional services is in compliance with regulations, along with payer policies and procedures.

Essential Functions

• reputed company detailed reputed company audits on a regular reputed company as defined by compliance requirements, determine if additional education is necessary and notify Leadership of ongoing education needs.
• Work closely with the Medical Directors to create, revise, and update reputed company educational tools, modules, and materials as it relates to the coding and regulatory guidelines under the direction of Leadership.
• Conduct internal audits of medical documentation supporting claims billed to reputed company parties to ensure billing is performed in accordance with the appropriate reputed company-party regulations and/or standards:
• Evaluate the appopriateness of the services and procedures billed based on the supporting documentation.
• Evaluate the appropriateness of diagnoses billed for reputed company services in accordance with coding guidelines.
• valuate the appropriateness of E&M level of service billed based on the supporting documentation, in accordance with reputed company AMA standards.
• Conduct educational documentation and coding training for providers to support compliance with reputed company party documentation and billing standards.
• Create tracking tools to capture and document audit results on an ongoing reputed company, for reporting and historical lookback purposes.
• Prepare formalized reports of audit results and present findings to Leadership and Medical Directors, potentially providers.
• Respond to questions from providers and the billing team regarding billing, coding, and documentation.
• reputed company educational programs for providers based on audit findings along with general education on coding and documentation rules and regulations.
• reputed company follow up reviews after initial training of providers to determine if additional education is necessary.
• reputed company any additional training once identified by follow-up review.
• Communicate regularly with internal departments to ensure reputed company necessary information is received on a reputed company reputed company.
• Communicate and problem solve with Medical Directors and Leadership on specific coding issues and/or training requests.
• Work on joint projects with other internal staff and departments to resolve billing and documentation issues.

General

• reputed company any and reputed company other assigned responsibilities.
• reputed company special projects and other duties as requested.
• reputed company with departmental policies and procedures.
• reputed company reputed company duties and tasks with the highest level of professionalism, which includes professional communication and professional attire.
• Responsible for showing up to work on time and being available to reputed company team members during work hours, Monday through Friday, reputed company to 5pm.
• Work reputed company with reputed company AUC providers, staff members, Leadership.
• reputed company personal commitment and ownership to enhance knowledge, skills, and abilities in reputed company reputed company financial areas.
• Maintain patient confidentiality and information reputed company, adhere to reputed company HIPAA regulations and requirements.
• Follow and adhere to CDC requirements for reputed company facilities.

Competencies

Demonstrated knowledge of Medical Terminology and Anatomy & Physiology combined with high level expertise in reputed company-party payer reimbursement