Healthcare Coding Auditor & Compliance Analyst

Triple-S Management Corp.; Northern (KY); Hybrid; USD 65,000 - 95,000; Full time

Job summary

Triple-S Management Corp. is seeking a skilled coder/auditor to review medical records and coding data for accuracy and regulatory compliance.

The role collaborates with risk adjusters, billers, and providers to improve documentation and reimbursement processes. The ideal candidate will have a CPC certification and a minimum of two years of related experience, preferably in outpatient settings, with strong analytical and training abilities.

Qualifications

• Bachelor's degree required.
• Minimum of two years of related experience in outpatient setting.
• CPC - Certified Professional Coder or equivalent certification preferred.

Responsibilities

• Audit medical records, billing data and coding documentation for accuracy and compliance.
• Provide feedback, training and recommendations to clinicians and billers.
• Review and support correct coding to ensure proper reimbursement from insurers and government programs.
• Identify gaps and trends in documentation and escalate issues with providers and staff.
• Prepare reports and action plans based on analysis for management review.
• Stay current with coding standards and healthcare regulations; participate in training sessions.

Skills

Auditing

Medical Coding

Risk Adjustment

Regulatory Compliance

Training & Feedback

Communication

Education

Bachelor's Degree in Business Administration or Health

Job description

Triple-S Management Corp. is seeking a skilled coder/auditor to review medical records and coding data for accuracy and regulatory compliance.

The role collaborates with risk adjusters, billers, and providers to improve documentation and reimbursement processes. The ideal candidate will have a CPC certification and a minimum of two years of related experience, preferably in outpatient settings, with strong analytical and training abilities.