Medical Coding Quality & Compliance Specialist

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

Job summary

Southwest Network is seeking a skilled medical coder auditor to audit charts and ensure coding accuracy. You will analyze clinical records for proper codes and modifiers, identify denials risk patterns, and stay current with evolving guidelines. The role includes coaching staff and communicating audit findings to providers.

Collaborating with IT and EHR teams, you will help improve workflows and support the corporate compliance program through ad-hoc audits and documentation reviews.

Responsibilities

• 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

Job description

Southwest Network is seeking a skilled medical coder auditor to audit charts and ensure coding accuracy. You will analyze clinical records for proper codes and modifiers, identify denials risk patterns, and stay current with evolving guidelines. The role includes coaching staff and communicating audit findings to providers.

Collaborating with IT and EHR teams, you will help improve workflows and support the corporate compliance program through ad-hoc audits and documentation reviews.