Healthcare Coding Auditor & QA Specialist

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

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.