Coding Auditor Professional - Remote

McLaren Health Care; Shelby Township (MI); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare provider seeks a Coding Specialist to enhance documentation and coding accuracy. The role involves conducting audits, training staff, and ensuring compliance with coding guidelines. Candidates should have relevant experience and certifications in healthcare coding.

Qualifications

• 1 year evaluation and management (E&M) coding experience.
• 3 years’ experience in surgical and outpatient procedural coding.
• Certified in AHIMA, AAPS, or AMAC.

Responsibilities

• Complete quality assurance audits on coding specialists.
• Optimize reimbursement and data quality.
• Perform audits to ensure coding accuracy and compliance.

Skills

Quality Assurance Audits

Data Analysis

Documentation Improvement

Coding Compliance

Education

Associate degree in HIT, Applied Science, Liberal Arts or related healthcare field

Job description

Position Summary: Responsible for working with physicians, coders, ancillary department staff, Clinical Documentation Improvement (CDI), and other allied health professionals to improve documentation of patient care and appropriately assign codes and/or determine charges to support those services.

Essential Functions and Responsibilities As Assigned:

• Responsible for completing quality assurance audits on professional coding specialists, onboarding audits and training of newly hired coding specialists, validating the coding specialist is accurately abstracting data into medical record systems, following coding guidelines, and relevant federal and other pertinent materials.
• Optimizes prospective payment reimbursement and facilitates data quality by creating consistency and efficiency in physician documentation, code assignment, data collection, and claims processing.
• Performs retrospective, random, and focused audits of coding cases to ensure correct coding, legal compliance, and complete charge capture.
• Evaluates the proper assignment of procedure, modifier, and diagnosis codes to professional services to validate accuracy and compliance.
• Reports quality results, tracking and trending of educational opportunities of the coding specialist and provides educational support and training.
• Gathers, transfers, and analyzes all auditing results to capture and demonstrate risk issues, revenue leakage and educational opportunities.
  
  

Required:

• Associate degree in HIT, Applied Science, Liberal Arts or related healthcare field
• 1 year evaluation and management (E&M) coding experience in any medical specialty
• 3 years’ experience in surgical and outpatient procedural coding is required.
• Certified in at least one of the following:
• AHIMA Certification (such as: RHIA, RHIT, CCS)
• AAPS Certification (such as: CPC, CCS-P, CCC, COC, CIC, CHONC, etc.)
• AMAC Certification such as ROCC (Radiation Oncology Certified Coder)
  
  

Preferred:

• 1 year audit experience
  
  

Additional Information

• Schedule: Full-time
• Requisition ID: 25001377
• Daily Work Times: Standard Business Hours
• Hours Per Pay Period: 80
• On Call: No
• Weekends: No