DHA Medical Coding Auditor - Compliance & QA

Serco; Salem (OR); A distancia; USD 90.000 - 120.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health Insurance (Medical, Dental, & V

Vacation & Sick Leave

401(k) with Employer Matching

Tuition Reimbursement

Life & Disability Insurance

Employee Assistance Plan

Descripción de la vacante

Serco is seeking a Medical Coding Auditing Specialist to support the Defense Health Agency’s Medical Coding Program Branch. The role involves auditing MTFs and dental clinics across DHA markets, developing annual audit work plans, and performing targeted coding and documentation audits.

The position requires extensive knowledge of ICD-CM, CPT, and related reimbursement models, with a focus on enterprise risk factors and compliance with CMS LCD/NCD guidelines.

Formación

• Associate degree or higher in Health Information Management or Healthcare Administration or biological science, OR
• Certification in medical coding or related coursework, OR
• 30+ semester hours with relevant coursework; OR
• AAPC/AHIMA course in coding concepts; OR
• Armed Forces medical training program with supervision.

Responsabilidades

• Perform routine audits of DHA Markets MTFs and Dental clinics.
• Support DHA-MCPB in annual audit work plan based on enterprise risk.
• Conduct targeted coding/documentation audits as directed.
• Assist in government surveillance audits of DHA medical coding contracts.
• Provide required education documentation in qualification packages.

Conocimientos

ICD-CM/PCS/CPT

PPS/DRGs/APCs/RBRVS

Medical terminology & pharmacology

Government coding rules & audits

Revenue cycle management

CDT knowledge

Educación

Associate degree in HIM/Healthcare Admin/Bio Sci

Certification course in medical coding

30+ credits in anatomy/physiology/medical terminology

AAPC/AHIMA coding exam prep course

Armed Forces training program in medical tech supervision

Descripción del empleo

Serco is seeking a Medical Coding Auditing Specialist to support the Defense Health Agency’s Medical Coding Program Branch. The role involves auditing MTFs and dental clinics across DHA markets, developing annual audit work plans, and performing targeted coding and documentation audits.

The position requires extensive knowledge of ICD-CM, CPT, and related reimbursement models, with a focus on enterprise risk factors and compliance with CMS LCD/NCD guidelines.