Coding Auditor & Educator

WelbeHealth; Los Angeles (CA); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical insurance coverage

17 days PTO + 12 holidays + sick time

401K savings + match

Advancement opportunities

And additional benefits

Job summary

WelbeHealth is seeking a Coding Auditor and Educator to ensure accurate coding and proper documentation within health records. You will educate teams on best practices and support CMS risk adjustment coding guidelines across PACE programs.

The role requires CCS or CPC credentials, extensive ICD-10 knowledge, and MEAT application experience. A detailed, collaborative approach with the coding team is essential.

Qualifications

• Associates Degree preferred; three (3) years of relevant experience may be substituted in lieu of a degree.
• Minimum of four (4) years of related experience or a combination of healthcare-related education and experience in coding and auditing.
• Minimum of two (2) years of Risk Adjustment (HCC) coding experience in a managed care environment.
• Current CCS, CCS-P, CPC, CPC-H, CPMA, or CRC credential.
• Strong knowledge of ICD-10 coding standards.
• Experience in the correct application of M.E.A.T. concepts.
• Comfortable in Microsoft Office (Outlook, Word, Excel, and PowerPoint)

Responsibilities

• Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants
• Conduct pre-visit chart preparations and post-visit chart reviews
• Oversee audits and participate in provider education programs to ensure compliance with CMS risk adjustments diagnosis coding guidelines
• Work closely with Coding Supervisor in identifying opportunities for HCC coding education

Skills

ICD-10 coding standards

MEAT concepts

Microsoft Office

Risk Adjustment (HCC) coding

Healthcare auditing

Education

CCS/CCS-P/CPC/CPC-H/CPMA/CRC credentials

Tools

MS Office

Job description

WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission.

At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance.

• Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants
• Conduct pre-visit chart preparations and post-visit chart reviews
• Oversee audits and participate in provider education programs to ensure compliance with CMS risk adjustments diagnosis coding guidelines
• Work closely with Coding Supervisor in identifying opportunities for HCC coding education

Job Requirements:

• Associates Degree preferred; three (3) years of relevant experience may be substituted in lieu of a degree
• Minimum of four (4) years of related experience or a combination of healthcare-related education and experience in coding and auditing
• Minimum of two (2) years of Risk Adjustment (HCC) coding experience in a managed care environment
• Current CCS, CCS-P, CPC, CPC-H, CPMA, or CRC credential
• Strong knowledge of ICD-10 coding standards
• Experience in the correct application of M.E.A.T. concepts
• Comfortable in Microsoft Office (Outlook, Word, Excel, and PowerPoint)

Benefits of Working at WelbeHealth: Apply your coding expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.

• Medical insurance coverage (Medical, Dental, Vision)
• Work/life balance - we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and sick time
• 401K savings + match
• Advancement opportunities - we've got a track record of hiring and promoting from within, meaning you can create your own path!
• And additional benefits

Compensation consists of base salary plus bonus. WelbeHealth offers a competitive total rewards package that includes a 401(k) match, comprehensive healthcare coverage, and a broad range of additional benefits. Actual compensation will be determined based on experience and relevant qualifications.

$70,304 - $89,535.30 USD

At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.

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At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.

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