Medical Coder

AAPC; Phoenix (AZ); On-site; USD 65,000 - 90,000; Full time

Job summary

AAPC in Phoenix, AZ is seeking a medical coding audit professional to review charts and clinical records, ensuring accurate diagnostic and procedural codes and modifiers. You will identify trends that could lead to denials, comply with coding guidelines, and train staff across specialties based on audit findings.

You will also follow up on unclear information with rendering providers, collaborate with IT/EHR teams to optimize workflows, and conduct ad-hoc audits to maintain coding fidelity.

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
• Provides targeted education, direct coaching, and facilitates training programs tailored to each medical specialty upon translating audit findings
• Follows up and clarifies any information that is 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

Responsibilities

• Audit charts and clinical records for compliance with diagnostic and procedural codes and modifiers.
• Identify coding trends and potential denials; communicate findings to relevant teams.
• Ensure adherence to medical coding guidelines and monitor regulatory changes.
• Educate and coach staff; translate audit findings into training for specialties.
• Clarify ambiguous information with rendering providers to ensure accuracy.
• Collaborate with IT/EHR teams to improve workflows and automation.
• Perform ad-hoc audits to verify coding fidelity.
• Serve as expert for Southwest Network on coding practices.
• Analyze medical records to identify documentation gaps.

Job description

Job Details

Essential Functions:

• 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
• Provides targeted education, direct coaching, and facilitates training programs tailored to each medical specialty upon translating audit findings
• Follows up and clarifies any information that is 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.