Medical Billing & Coding Specialist

Southwest Network; Phoenix (AZ); On-site; USD 65,000 - 92,000; Full time

Job summary

Southwest Network seeks a skilled Auditing/Medical Coding professional to audit charts and clinical records, ensuring correct procedure and diagnosis codes. You will identify coding trends, support training, and coordinate with IT/EHR teams to optimize workflows.

Responsibilities include conducting ad-hoc audits, ensuring regulatory compliance, and providing targeted education for medical specialties to improve overall coding accuracy.

Qualifications

• Auditing charts and reviewing clinical records to ensure codes and modifiers are correct.
• Identifying trends in improper coding or potential audit triggers.
• Complying with medical coding guidelines and regulatory changes.
• Providing targeted education and training tailored to medical specialties.

Responsibilities

• Audits charts and reviews clinical records to ensure all diagnostic and procedural codes and modifiers are accurate.
• Identifies trends in improper coding or communication gaps that may lead to denials or audits.
• Collaborates with IT and EHR teams to improve charge automation and optimize workflows.
• Conducts ad-hoc audits to ensure fidelity to coding guidelines.
• Analyzes medical records to identify documentation deficiencies.

Skills

Auditing

Medical coding

Quality assurance

Training and education

Communication

Tools

EHR systems

Charge automation

Job description

• Audits charts and revies clinical records ensuring all diagnostic and procedural codes and modifiers strictly adhere
• Identifies trends in improper coding or other communication shortcomings that may lead to claim denials or audits
• Complies with all medical coding guidelines and monitors evolving regulatory and industry changes
• Provides targeted education, direct coaching, and facilitates training programs tailored to each medica specialty upon translating audit findings
• Follows up and clarifies any information that i s not clear with the rendering provider
• Collaborates with IT and EHR teams to improve charge automation and optimize workflows
• Conducts ad-hoc audits to ensure fidelity to coding guidelines
• Relevant expert for Southwest Network on accurate and efficient coding practices
• Analyze medical records and identify documentation deficiencies

Nonessential Functions:

• Follows policies and procedures and adheres to the requirements of the Corporate Compliance Program
• Ensures confidentiality of verbal and written information in accordance with HIPAA standards and Southwest Network policy, and adheres to the legal, ethical and professional guidelines adopted by Southwest Network
• Other duties as assigned

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.