Coding Auditor - University Health Network

University Physicians' Association, Inc. (UPA); Knoxville (TN); On-site; USD 70,000 - 98,000; Full time

Job summary

University Physicians' Association, Inc. (UPA) is seeking a UHN Auditor to join the Knoxville, TN region. The role focuses on auditing and improving coding and documentation, educating staff, and implementing quality assurance programs to enhance accuracy and compliance.

The ideal candidate will have 3+ years of ICD-10-CM, CPT, and HCPCS experience, CPC/CPMA certifications, and CRC within 6 months. Strong confidentiality, analytical, and communication skills are required to succeed.

Qualifications

• 3+ years of ICD-10, CPT, and HCPCS coding experience.
• Knowledge of Risk Adjustment Coding.
• Current certifications CPC (RHIT also accepted) and CPMA.
• CRC required within 6 months of hire.
• Strong understanding of Medicare/Medicaid billing regulations and documentation guidelines.
• Confidentiality and professional conduct essential.

Responsibilities

• Assist Coding Manager in developing and maintaining a quality assurance program.
• Perform audits and chart reviews to improve coding and documentation compliance.
• Use the UHN Audit tool to assign accuracy rates and monitor performance.
• Provide feedback and education to Coding Staff on accuracy scores.
• Collaborate on improvement plans when accuracy falls below standards.
• Develop effective training materials on correct coding techniques.
• Conduct external coding audits and create audit summary reports.
• Deliver audit results and education to providers.
• Contribute to policies ensuring compliance with state and federal regulations.
• Maintain data accuracy, completeness, and confidentiality.
• Stay current on ICD-10-CM, AHA Coding Clinic Guidance, and CMS Risk Adjustment guidance.
• Handle ambulatory and inpatient coding assignments as needed.

Skills

ICD-10 coding

CPT coding

HCPCS coding

Risk Adjustment Coding

Auditing

Communication skills

Attention to detail

Time management

Analytical thinking

Problem solving

Education

CPC certification

CPMA certification

RHIT accepted

CRC certification within 6 months

Tools

UHN Audit tool

Microsoft Word

Microsoft Excel

Job description

Description

Candidate must be located in the Knoxville, TN region.

UHN Auditor provides superior customer experience by educating internally and externally on errors and opportunities for improvement discovered during routine auditing. This individual will work closely with management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. The UHN Auditor performs duties in a professional manner while exercising good judgment and ethical standards, interacts effectively and builds respectful working relationships across the organization, and demonstrates integrity by adhering to high standards of personal and professional conduct. This individual must be reliable and maintain a high level of confidentiality within all aspects of job performance.

Essential Duties And Responsibilities

• Assists Coding Manager in developing and maintaining a quality assurance program
• Performs audits and medical chart reviews contributing to the continual improvement of coding and documentation compliance performance.
• Performs routine internal audits for the UHN Coding team utilizing the UHN Audit tool to assign accuracy rates.
• Provides feedback and education to Coding Staff on accuracy scores and areas of improvement while maintaining confidentiality of individual performance.
• Works with Coding Manager on improvement plan if team member’s accuracy rate falls below industry standard and monitors if improvement plan is achieving desired outcome.
• Assists in the development of an effective training program regarding correct coding techniques.
• Performs external coding audits for providers and creates audit summary reports with education topics.
• Delivers Audit results and educational opportunities to providers
• Assists in development of educational materials regarding compliant coding practices
• Acts as a Subject Matter Expert in coding and documentation compliance
• Conducts special studies/projects as requested to identify opportunities for operational improvements
• Assists in the maintenance and creation of departmental policies and procedures to ensure compliance with established State and Federal regulations.
• Monitors database entries to ensure data is complete, accurate, and thorough
• Remains current on ICD-10-CM coding guidelines, AHA Coding Clinic Guidance, and CMS Risk Adjustment guidance.
• Performs ambulatory and inpatient coding assignments as needed to meet department deadlines.

Requirements

• 3+ years of ICD-10, CPT, and HCPCS coding experience required.
• Experience and knowledge of Risk Adjustment Coding.
• Current certifications required: CPC (RHIT also accepted) and CPMA.
• Certified Risk Adjustment Coder (CRC) required within 6 months of hire.
• Thorough understanding of healthcare compliance with experience in auditing E/M services and providing professional constructive feedback regarding billing and documentation practices.
• Thorough understanding of Medicare/Medicaid billing regulations and documentation guidelines.
• Strong knowledge of chart auditing/abstracting process.
• Effective communication, relationship-building and interpersonal skills.
• Exceptional attention to detail and proficiency in Microsoft Word and Excel.
• Strong organizational and time management skills.
• Ability to work independently and meet quality of work and workload expectations.
• Strong analytical and problem‑solving skills.