Medical Coding Compliance Auditor

HealthFirst; EE. UU.; A distancia; USD 61.000 - 100.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental and vision coverage

Incentive and recognition programs

Life insurance

401k contributions

Descripción de la vacante

Healthfirst is seeking a Coding Auditor to conduct quality audits of medical coding submitted to CMS, NYSDOH, and other entities, ensuring documentation supports patients' health conditions.

You will audit data, claims, and medical records for completeness and accuracy, identify patterns of under-performance, and notify management of discrepancies. Collaboration across departments will drive improved coding and compliance.

Formación

• Certification required: AAPC CPC or AHIMA certification.
• High school diploma or GED required.
• Experience with medical coding and auditing is preferred.

Responsabilidades

• Audits data, claims, and member records for accuracy and compliance.
• Identifies noncompliance patterns and recommends resolutions.
• Evaluates coding quality and notifies management of discrepancies.
• Performs internal audits of colleagues' medical record reviews.
• Collaborates with other departments to improve coding conventions.
• Supports continuous quality improvement across departments.

Conocimientos

Time management

Critical thinking

Communication

Problem-solving

Caseload management

Fast-paced environment

Educación

AAPC CPC

AHIMA certification

High school diploma or GED

Descripción del empleo

Healthfirst is seeking a Coding Auditor to conduct quality audits of medical coding submitted to CMS, NYSDOH, and other entities, ensuring documentation supports patients' health conditions.

You will audit data, claims, and medical records for completeness and accuracy, identify patterns of under-performance, and notify management of discrepancies. Collaboration across departments will drive improved coding and compliance.