Coding Auditor- Medical Coding (Pain Management)

Bizmatics India; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company is seeking experienced Medical Coders to join their team. The ideal candidate will have a CPC certification and significant experience in the U.S. healthcare and RCM fields. Responsibilities include ensuring documentation accuracy, conducting audits, and providing training. This role offers the opportunity to impact quality coding practices within healthcare settings.

Qualifications

• CPC Certification is required.
• 3+ years experience in a clinic environment preferred.
• Knowledge of business office practices and insurance processes is essential.

Responsibilities

• Conduct monthly audits for coding documentation accuracy.
• Assist providers with coding questions and concepts.
• Manage claims and address denials related to coding.

Skills

Knowledge of CPT and ICD-10 codes

Understanding of third-party payers

Attention to detail

Communication

Education

CPC Certified

3+ years of clinic experience

Job description

Exciting Opportunities for Medical Coders

Interested candidate can share cv on [e-mail]

Looking candidate From US healthcare, RCM and Medical Coding Field

Role & responsibilities:

• Monthly audits for providers and mid-levels and coders to ensure documentation supports billing and provides feedback to drive improved documentation practices.
• Provides resolution to coding questions.
• Assist with provider questions and presents coding concepts to drive improved documentation practices
• Identifies coding trends and areas of risk
• Handles escalated coding questions because of claim denials
• Communicates adverse trends related to coding denials
• Research coding topics and LCDs to ensure compliance with payor requirements and payer specific guidelines
• Provide documentation training to providers and support staff as needed
• Reviews records for audit requests related to RAC audits, SRMC audits, prepayment reviews, etc. prior to appeals or other documentation being sent
• Manages unbilled patient encounters for office, ASC, hospital, and Pathology.
• Provides scrub claim logic for clean electronic submission to clearinghouse
• Protect the security of medical records to ensure confidentiality is maintained.
• Creates and/or updates the patients demographics and insurance information for new and established patients.
• Other duties as assigned

Requirements:

• CPC Certified (Required)
• 3+ years of experience in a clinic setting (Preferred)
• Preferred experience in Spine, Orthopedic or Pain Management
• Knowledge of CPT and ICD-10 codes
• Overall knowledge of business office procedures and policies (required)
• Thorough knowledge of third-party payers, HMOs, PPOs, Medicare and Medicaid.
• Ability to work independently with minimum supervision
• Correct coding for diagnosis and procedures
• Rely on experience and judgment to plan and accomplish goals.