Certified Coder / Audit Specialist

Summa Health

Cleveland (OH)

Hybrid

USD 63,000 - 76,000

Full time

35 hours ago

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Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Retirement Savings Plan

Flexible Spending Accounts

Employee Assistance Program

Daily Pay

Job summary

Summa Health System is seeking an experienced Medical Coding Auditor to review and audit medical records per Medicare/Medicaid standards. You will prepare detailed reports, deliver recommendations, and educate providers on coding compliance.

Requires two years’ experience in a physician office or hospital setting and CCS, CCS-P, CMC, CPC, CPMA certifications, with remote work possible after training.

Qualifications

Two years of work experience in a physician’s office or outpatient/in-patient setting performing documentation review per compliance and Medicare/Medicaid Standards.
Familiarity with medical terminology and HIPAA/compliance guidelines.
Two years of experience handling coding tests and chart reviews for accuracy.

Responsibilities

Audits medical records for SPI Physicians and providers per compliance measures.
Prepares and distributes recommendations and detailed reports of documentation issues.
Provides education and training to providers and staff on coding standards.
Serves as a resource on coding-related issues for SPI areas.

Skills

2 years coding reviews

Medical terminology familiarity

HIPAA/compliance understanding

Education

CCS

CCS-P

CMC

CPC

CPMA

Medical Auditor

Job description

Full-Time Days

Two (2) years of work experience in a physician’s office or Out-patient/In-patient setting performing documentation review per compliance and Medicare/Medicaid Standards, diagnostic code sequencing and familiarity to Medical Terminology required.
Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Certified Medical Coder (CMC), Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA) reqired.

Summa Health Medical Group

Akron, OH 44304

Full-Time Days

Will work remote after training and orientation

Two (2) years of work experience in a physician’s office or Out-patient/In-patient setting performing documentation review per compliance and Medicare/Medicaid Standards, diagnostic code sequencing and familiarity to Medical Terminology required.
Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Certified Medical Coder (CMC), Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA) reqired.

Summa Health System is recognized as one of the region’s top employers by a number of third party organizations, including NorthCoast 99. Exceptional candidates gravitate to Summa because of its culture, passion for delivering excellent service to our patients and families commitment to our philosophy of servant leadership, collegial working relationships at every level of the organization and competitive pay and benefits.

Summary

Audits medical records per compliance measures for all SPI Physicians and providers; prepares and distributes recommendations and result findings including detailed reports of medical chart documentation issues. Provides education and training to providers and staff. Functions as a resource on coding related issues for SPI areas.

Formal Education Required

Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Certified Medical Coder (CMC), Certified Professional Coder (CPC), Certified Professional
Medical Auditor (CPMA).

Passing score of 70% or better on an outpatient/inpatient coding test administered by the Manager

Experience And Training Required

Two (2) years of work experience in a physician’s office or Out-patient/In-patient setting performing documentation review per compliance and Medicare/Medicaid Standards, diagnostic code sequencing and familiarity to Medical Terminology

Other Skills, Competencies And Qualifications

Ability to understand and follow the all policies for Chart Reviews/Audits by Insurance Carriers, any government, state or local entity including HEDIS, CERT and RAC.
Knowledge in compliance to all guidelines including Medicare and Medicaid Standards.
Ability to review medical documentation written or within an EMR.
Understands and can perform job duties with the utmost level of confidentiality.
Understands and exhibits work practices to support HIPAA Regulations and abides by all measures of Compliance.
Knowledge in HIM, traditional medical charts and record storage.

Equal Opportunity Employer/Veterans/Disabled

$30.31/hr - $36.37/hr

The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.

Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits.