Clinic Data & Coding Audit Specialist

Methodist Hospital Sacramento; Sacramento (CA); On-site; USD 55,000 - 75,000; Full time

Job summary

Methodist Hospital Sacramento in Sacramento, CA is seeking a Clinic Data Audit Specialist with expertise in billing procedures and ICD/CPT coding in a clinic setting. You will verify documentation to ensure medical necessity for charges within the EMR before releasing charges.

Work closely with finance, accounting, and coding teams to ensure claims are properly coded and updated, and to educate providers on documentation to support accurate billing and compliance.

Qualifications

• Must have at least 1 year of experience in a medical environment handling insurance claims.
• Demonstrated knowledge of billing procedures and coding guidelines.
• Strong attention to detail to ensure accuracy in documentation and charges.

Responsibilities

• Audit and verify documentation accuracy to ensure medical necessity and correct charges.
• Collaborate with finance, accounting, and coding departments to ensure proper coding.
• Update the CDM dictionary and educate providers on documentation needs for ICD/CPT coding.
• Review encounters in Cerner PCA Charge Viewer to ensure a diagnosis charge and CoSigned documentation by a supervisor.
• Check BP codes for incentives and verify modifiers (GC with faculty / GE without faculty).
• Identify and delete duplicate office visit charges and validate charges.
• Assist in training providers on documentation and coding best practices.

Skills

Medical billing

ICD coding

CPT coding

Auditing

Regulatory compliance

Communication

Education

High School Diploma

GED

Tools

IDX systems

Cerner PCA Charge Viewer

Job description

Methodist Hospital Sacramento in Sacramento, CA is seeking a Clinic Data Audit Specialist with expertise in billing procedures and ICD/CPT coding in a clinic setting. You will verify documentation to ensure medical necessity for charges within the EMR before releasing charges.

Work closely with finance, accounting, and coding teams to ensure claims are properly coded and updated, and to educate providers on documentation to support accurate billing and compliance.