Medical Billing & Coding Specialist

Southwest Network, Inc.; Phoenix, Northern (AZ, KY); Hybrid; USD 60,000 - 90,000; Full time

Job summary

Southwest Network, Inc. in Phoenix seeks a Medical Coding Auditor to ensure accurate documentation and coding across patient records. The role focuses on auditing charts, reviewing clinical data, and enforcing diagnostic and procedural code accuracy to prevent denials and support compliant billing.

You will provide targeted education and coaching to clinicians, collaborate with IT/EHR teams to improve workflows, and stay current with evolving coding guidelines and regulatory changes.

Qualifications

• Audits charts and reviews 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

Responsibilities

• 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

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.