Medical Coding Auditor

Kids for the Future; Huntsville (AL); On-site; USD 46,000 - 66,000; Full time

Job summary

Kids for the Future is seeking a Medical Coding Auditor to support our healthcare team in Huntsville, AL. You will review medical records, validate diagnoses and procedures, conduct internal coding audits, and implement corrective action plans to ensure compliance with HIPAA and payer guidelines.

The role requires a 2-year degree and CPC or CCS certification, with 3+ years of outpatient coding experience. Proficiency in eClinicalWorks and MS Office is preferred.

Qualifications

• Proven experience as a Medical Coding Auditor or similar role in healthcare.
• Excellent knowledge of medical coding guidelines and regulations, including ICD-10, CPT, and HCPCS.
• Ability to review and analyze clinical records and medical reports.

Responsibilities

• Review and verify the accuracy of medical records, codes and billing data.
• Conduct audits on medical coding to ensure accuracy and compliance with guidelines and regulations.
• Review medical documents to validate diagnoses, procedures, and treatment codes.

Skills

Medical coding auditor

ICD-10 CPT HCPCS

HIPAA compliance

Auditing experience

Analytical skills

Communication skills

MS Office

eClinicalWorks

Education

2-year degree

CPC or CCS

Health Information Management

Tools

eClinicalWorks

Microsoft Office

Job description

• Base Pay $21.89 - $31.51 / Hour
• Employee Type FT Non-Exempt
• Required Degree 2 Year Degree

Contact information

• Phone [phone]

Description

The Medical Coding Auditor provides technical support to medical providers, as appropriate, regarding accurate and compliant coding documentation, regulatory provisions and third-party payer requirements. This position will be responsible for conducting internal audits of medical coding and billing activities to ensure compliance with regulatory standards and guidelines. The responsibilities include reviewing and validating medical documents, identifying and correcting coding errors, and implementing corrective action plans.

Requirements

Duties and Responsibilities

• 1. Review and verify the accuracy of medical records, codes and billing data.
• 2. Conduct audits on medical coding to ensure accuracy and compliance with guidelines and regulations.
• 3. Review medical documents to validate diagnoses, procedures, and treatment codes.
• 4. Review medical records that have been reviewed and coded by the third-party billing company.
• 5. Investigate any discrepancies or inconsistencies in medical documentation and coding.
• 6. Train and provide feedback to Providers and medical coders on correct coding practices.
• 7. Stay current with changes in medical coding and billing regulations and guidelines.
• 8. Assist in the development and implementation of coding policies and procedures.
• 9. Assist if needed in requesting records or support.
• 10. Prepare and present reports on audit results and recommendations for improvement.
• 11. Monitor the effectiveness of corrective actions and improvement initiatives.
• 12. Ensure compliance with Health Insurance Portability and Accountability Act (HIPAA) and other relevant laws
• 13. Participate in regulatory audits and inspections.
• 14. Participate in medical billing meetings.
• 15. Other duties as assigned.

Knowledge, Skills, and Abilities

• Proven experience as a Medical Coding Auditor or similar role in healthcare.
• Excellent knowledge of medical coding guidelines and regulations, including ICD-10, CPT, and HCPCS.
• Ability to review and analyze clinical records and medical reports.
• Ability to work independently and make informed decisions based on thorough analysis and research.
• Strong analytical and problem‑solving skills to identify discrepancies or inconsistencies in medical coding and billing.
• Excellent communication and presentation skills to convey audit findings clearly and concisely to healthcare professionals and management.
• Proficiency in MS Office, coding software, our EHR is e-Clinical Works.
• Attention to detail and accuracy.
• Continuous learning and adaptability to stay updated with changes in healthcare regulations and coding guidelines.
• Ability to multitask and prioritize. Excellent organizational and time‑management skills.
• Ability to maintain confidentiality of privileged information obtained in the course of work

Software Access

• Microsoft Office
• eClinicalWorks

Minimum Qualifications

• Certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) is required.
• Associate’s or Bachelor’s degree in Health Information Management or related field is preferred.
• 3+ years coding of experience including outpatient coding skills, evaluation and management, auditing, report‑writing expertise, required
• Must understand Behavioral Health Claims, and Telehealth.

Summary

Duties and Responsibilities

• 1. Review and verify the accuracy of medical records, codes and billing data.
• 2. Conduct audits on medical coding to ensure accuracy and compliance with guidelines and regulations.
• 3. Review medical documents to validate diagnoses, procedures, and treatment codes.
• 4. Review medical records that have been reviewed and coded by the third-party billing company.
• 5. Investigate any discrepancies or inconsistencies in medical documentation and coding.
• 6. Train and provide feedback to Providers and medical coders on correct coding practices.
• 7. Stay current with changes in medical coding and billing regulations and guidelines.
• 8. Assist in the development and implementation of coding policies and procedures.
• 9. Assist if needed in requesting records or support.
• 10. Prepare and present reports on audit results and recommendations for improvement.
• 11. Monitor the effectiveness of corrective actions and improvement initiatives.
• 12. Ensure compliance with Health Insurance Portability and Accountability Act (HIPAA) and other relevant laws
• 13. Participate in regulatory audits and inspections.
• 14. Participate in medical billing meetings.
• 15. Other duties as assigned.

Knowledge, Skills, and Abilities

• Proven experience as a Medical Coding Auditor or similar role in healthcare.
• Excellent knowledge of medical coding guidelines and regulations, including ICD-10, CPT, and HCPCS.
• Ability to review and analyze clinical records and medical reports.
• Ability to work independently and make informed decisions based on thorough analysis and research.
• Strong analytical and problem‑solving skills to identify discrepancies or inconsistencies in medical coding and billing.
• Excellent communication and presentation skills to convey audit findings clearly and concisely to healthcare professionals and management.
• Proficiency in MS Office, coding software, our EHR is e-Clinical Works.
• Attention to detail and accuracy.
• Continuous learning and adaptability to stay updated with changes in healthcare regulations and coding guidelines.
• Ability to multitask and prioritize. Excellent organizational and time‑management skills.
• Ability to maintain confidentiality of privileged information obtained in the course of work

Software Access

• Microsoft Office
• eClinicalWorks

Minimum Qualifications

• Certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) is required.
• Associate’s or Bachelor’s degree in Health Information Management or related field is preferred.
• 3+ years coding of experience including outpatient coding skills, evaluation and management, auditing, report‑writing expertise, required
• Must understand Behavioral Health Claims, and Telehealth.