Coding Compliance Auditor & Educator

Riverside Healthcare; Kankakee (IL); On-site; USD 38,572 - 50,971; Full time

Benefits offered by this job

Health and welfare benefits

Educational Assistance Program

Defined contribution retirement plans

Paid Time Off

Job summary

Riverside Healthcare in Illinois seeks a Professional Coding Compliance Specialist to audit ICD-10-CM and CPT/HCPCS codes across a multi-specialty group. You will provide education to providers and coders, maintain current coding guidelines, and support with newsletters and compliance initiatives.

The role requires 3+ years of coding experience, CPC certification, and commitment to ongoing professional education.

Qualifications

• Minimum three years current ICD-10-CM and CPT/HCPCS (including E/M assignment) coding experience in a multi-specialty medical practice or comparable coding experience required
• AAPC/CPC (Certified Professional Coder) required
• AAPC/CPMA (Certified Professional Medical Auditor) strongly recommended at hire; required within two years of hire
• AAPC/CRC (Certified Risk-Adjustment Coder) strongly recommended

Responsibilities

• Completes timely audits of assigned providers and coders for accurate, complete, and compliant ICD-10-CM and CPT/HCPCS code assignment, ensuring that documentation supports the diagnoses reported, E/M level selected, and CPT/HCPCS codes submitted for services rendered during the episodes of care reviewed
• Reviews audit findings with assigned providers and coders, providing real-time education on opportunities identified and offering objective supporting documentation to support findings
• Documents audit results in designated Excel log as soon as review is completed
• Immediately reports adverse audit trends, potential areas of risk, and compliance concerns to management
• Assists coding compliance lead in creating and publishing monthly provider newsletter
• Collaborates with coding compliance team and provider-focused coding manager to develop and maintain current coding guidelines
• Participates in developing and presenting provider and coder education programs
• Assists in orienting and educating new team members
• Serves as coding compliance resource to Riverside Medical Group and Riverside Medical Center as requested
• Assists in provider-focused coding and charge entry as needed to meet fiscal deadlines

Skills

Auditing codes

ICD-10-CM

CPT/HCPCS

Education delivery

Regulatory knowledge

Education

High school graduate

AAPC/CPC

CPMA within 2 years

CRC recommended

Associate degree preferred

Tools

Excel

Job description

Riverside Healthcare in Illinois seeks a Professional Coding Compliance Specialist to audit ICD-10-CM and CPT/HCPCS codes across a multi-specialty group. You will provide education to providers and coders, maintain current coding guidelines, and support with newsletters and compliance initiatives.

The role requires 3+ years of coding experience, CPC certification, and commitment to ongoing professional education.