Outpatient Coding Auditor

Signature Performance; United States; On-site; USD 39,000 - 41,000; Full time

Benefits offered by this job

Health Insurance

Fully Paid Life Insurance

Fully Paid Short- & Long-Term,

Paid Vacation

Paid Holidays

Professional Development and Tuition

401(k) Program with Employer Match

Job summary

Signature Performance, Inc. seeks an Outpatient Coding Auditor to perform quality reviews and audits, coordinating with department managers to ensure policy compliance. You will identify documentation issues and deliver actionable feedback to coders and staff.

The role requires 5+ years in professional medical coding/reimbursement, with AHIMA/AAPC credentials preferred. Experience with ICD-10-CM/PCS, CPT-4, HCPCS and multi-specialty outpatient clinics is valued.

Qualifications

• Advanced knowledge of ICD-10-CM, ICD-10-PCS, CPT-4 and HCPCS.
• Practical knowledge of PPS, DRGs and APCs.
• Creates clear audit findings and recommendations in written reports.
• Identifies documentation issues impacting coding accuracy and communicates improvements.
• Guides staff in resolving coding issues and trend analysis for improvement.
• Continuing education on changes in coding and reimbursement systems.
• Formal coding program completion; AHIMA/APAC credentials preferred (CCS, RHIT, CIC, CPC).
• 5+ years in professional medical coding/reimbursement; CPMA preferred or obtainable within 12 months.

Responsibilities

• Create audit findings and recommendations for coders, auditors, managers and directors.
• Communicate opportunities for documentation improvement verbally and in reports.
• Provide guidance to staff on identifying and resolving coding issues and trends.
• Deliver continuing education on coding changes and reimbursement systems.

Skills

ICD-10-CM/PCS

Auditing experience

Documentation improvement

Project management

Education

Formal coding program

AHIMA/APAC credentials preferred

Tools

Cerner

EPIC

3M 360 Encompass

Microsoft Office

Job description

You are a person who enjoys ensuring coding accuracy and solving documentation and compliance challenges. We need someone who demonstrates skills in organization, prioritization, professionalism, and coaching others. In the role of Outpatient Coding Auditor, you will be responsible for quality reviews and audits and coordinating with department managers to ensure standards are met in accordance with department and organization policies.

• Tell us about your experience with Outpatient Coding Auditing.
• Are you a team player and a self-motivator?
• What is your experience with conducting business in a way that is credit to a company?
• We are counting on you to manage multiple projects using your problem-solving skills.
• We are looking for someone UNCOMMON. What is uncommon about you?

Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you.

About The Position

• Advanced knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM), Procedural Coding System (PCS), Current Procedural Terminology (CPT-4 and Healthcare Common Procedure Coding System (HCPCS).
• Practical knowledge of reimbursement systems, including Prospective Payment System (PPS), Diagnostic Related Groupings (DRGs), and Ambulatory Payment Classification (APC).
• Creates clear and accurate audit findings and recommendations in written audit reports that will be used for advising and educating Coders, Auditors, Managers, and Directors throughout the organization. Delivers educational feedback to coding staff regarding audit findings.
• Identify documentation issues (lacking documentation, missed physician queries, etc.) that impact coding accuracy. Clearly communicates (verbally and in written reports or summaries) opportunities for documentation improvement related to coding issues.
• To provide guidance to other departmental staff in identifying and resolving coding issues and/or error trends for improvement.
• Provides continuing education to individual coders and to the coding staff concerning changes in the coding and reimbursement system as well as any area of weakness identified during the performance of coding validation reviews.
• Completion of a formal coding program with preference given to AHIMA and AAPC credentials (CCS, RHIT, CIC, CPC). 5+ years of progressive experience in professional medical coding/reimbursement
• Currently holds national auditing credential with preference given to AAPC credential (CPMA), or be capable of attaining within 12 months from start date.
• Coding work experience encompassing a working knowledge of the ICD-10-CM and ICD[1]10-PCS; medical terminology; anatomy and physiology; and health record content.
• Comprehensive understanding of coding guidelines, Coding Clinics and appropriate coding references along with the ability to employ these coding resources to audit findings.
• Experience with Multi-Specialty Outpatient Clinic for Facility and Pro-fee services is preferred.
• Ability to work in multiple client systems and proficiency with Microsoft office applications.
• Cerner, EPIC and 3M 360 Encompass experience preferred
• Academic medical facility and professional services auditing experience preferred

About Us

You are uncommon. We are, too. We are looking for people to help us in our mission of working hard at lowering healthcare administrative costs for federal government agencies, payers, and providers. At Signature, our mission is to improve the health of our clients' business and make the lives of the people we work with better. As we continue to experience exponential growth, we are looking for uncommon individuals to enhance our vision. We will continue to accomplish our mission by leading with our values of Passion, Courage, Integrity, and Respect in all interactions, making us a consistent annual Best Places to Work organization. We need uncommon leaders with uncommon qualities to shape our uncommon culture and achieve our uncommon mission.

About the Benefits

When you are a member of Signature Performance, you are a part of a solutions-based organization where the values of passion, integrity, courage, and respect are the driving forces behind all our decision-making. We trust you to do important work and bring the best version of yourself to work every day, so we want to help you achieve a work-life balance while consistently challenging yourself. Signature believes in fully developing each one of our Associates. Our performance-driven philosophy boasts competitive pay and additional position specific incentives, where world-class training and development, resources, and events drive our award-winning culture where everyone thrives.

• Health Insurance
• Fully Paid Life Insurance
• Fully Paid Short- & Long-Term Disability
• Paid Vacation
• Paid Holidays
• Professional Development and Tuition Assistance Program
• 401(k) Program with Employer Match

Security Requirements

• U.S. Citizenship or naturalized citizenship is required for this position.
• All work on all positions at Signature Performance must be completed in the continental United States, Alaska, or Hawaii.
• Signature Performance requires candidates to participate in interviews with their camera enabled. Interviews may be recorded for evaluation, training, quality assurance, and hiring purposes. Candidates will be provided the opportunity to consent during the application process and notified before recording begins. These requirements are applied consistently to all applicants and are a condition of participation in the selection process. Failure to meet these requirements may result in removal from consideration. Candidates who have questions, concerns or require accommodation regarding recording should notify the Talent Attraction & Strategy team before proceeding.

Security Requirements

Work Schedule

8 hours daily between 6:00a - 6:00p Eastern Time Monday - Friday

Compensation Range

$28.00 - $30.00/Hour

Position Type

Full Time

This Company is an Equal Opportunity Employer, and does not discriminate on the basis of race, gender, ethnicity, religion, national origin, age, disability, veteran status, or on any other basis prohibited by law. Information on race, gender and national origin will only be used for statistical and recordkeeping purposes, and will not be used in making any employment decisions. All information provided will be kept separate from your expression of interest. Providing this information is strictly voluntary, and you will not be subjected to any adverse action or treatment if you choose not to provide this information. If you do not choose to answer these questions, we ask that you select "Decline to Identify" for each question. Thank you for your voluntary cooperation.