Coding Auditor: Compliance & Audit Specialist

Desert Oasis Healthcare; Palm Springs (CA); Hybrid; USD 85,000 - 120,000; Full time

Job summary

Desert Oasis Healthcare and Family Hospice Care is seeking a Coding Auditor to review documentation and medical records to ensure accurate coding of services and diagnosis. This role will collaborate with providers to improve clinical documentation and ensure compliance with governmental and regulatory requirements.

Responsibilities include serving as a subject matter expert for the coding team, completing annual provider documentation validation audits, and performing concurrent chart reviews.

Qualifications

• High school diploma or equivalent and a formal Coding Program completed.
• Current AHIMA or AAPC coding certification (CCS, CCS-P, CPC, CCA) and RAC/CRC certification preferred.
• 3 years coding experience including documentation audits and HCC management.
• Knowledge of diagnosis codes, HCC categories and CMS guidelines.
• Proficient with MS Office (Word, Excel, PowerPoint).
• Strong verbal and written communication across all levels of the organization.
• Effective time management and deadline prioritization.
• Hybrid telecommuting potential per management.

Responsibilities

• Serve as a resource and subject matter expert for coding teams and providers to ensure top-tier coding and documentation specificity.
• Complete annual provider documentation validation audits including record requests and reports.
• Perform concurrent chart reviews and report findings to management and providers.
• Coordinate RADV audits with Health Plans and share results with management.
• Conduct monthly prevalence reviews for targeted HCC categories and present results as needed.
• Utilize reports to validate codes, ensure data accuracy, and submit necessary corrections.
• Manage all aspects of assigned coding projects and collaborate on tasks as needed.
• Escalate concerns to department management and maintain accountability.

Skills

Communication skills

Time management

Accountability

Professional demeanor

Positive attitude

Education

High school diploma or equivalent

Coding program completion

AHIMA/AAPC certifications (CCS/CCS-P/CPC/CCA)

RAC/CRC certification

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Job description

Desert Oasis Healthcare and Family Hospice Care is seeking a Coding Auditor to review documentation and medical records to ensure accurate coding of services and diagnosis. This role will collaborate with providers to improve clinical documentation and ensure compliance with governmental and regulatory requirements.

Responsibilities include serving as a subject matter expert for the coding team, completing annual provider documentation validation audits, and performing concurrent chart reviews.