Outpatient Coding Auditor & QA Specialist

Nuvance Health; United States; On-site; USD 38,000 - 72,000; Full time

Benefits offered by this job

PTO

Medical Coverage

Dental Coverage

Vision Coverage

Health Savings Account

401(k) Plan

Life Insurance

Wellness Programs

Employee Assistance Program

Team Member Discounts

Job summary

Nuvance Health is seeking a Coding Auditor to perform high-volume internal reviews of physician practice records, ensuring accurate documentation and coding in line with CMS and internal policies.

The role includes delivering education sessions for coders and physicians, collaborating with the Compliance team, and staying up to date with evolving regulations and payer guidelines to support compliant revenue practices.

Qualifications

• Requires advanced expertise in medical terminology, anatomy, physiology, documentation, coding guidelines, state and federal regulations.

Responsibilities

• Conducts high volume internal audits of physician practice medical records for documentation and coding accuracy.
• Conducts education sessions for coders and physician practices based on audit findings to reinforce proper documentation and coding.
• QA activities auditing levels of service of surgical coding performed by Outpatient Coding team for accuracy.
• Collaborates with Compliance on audits, reporting, and issue resolution.
• Keeps current with CMS/NGS/NGS materials, OIG Work Plan, and payer guidelines to ensure compliant practices.

Skills

Auditing

Coding

Documentation

Regulatory compliance

Education sessions

Education

CPC

CPC-H

CCS-P

CPMA

CDEO

Job description

Nuvance Health is seeking a Coding Auditor to perform high-volume internal reviews of physician practice records, ensuring accurate documentation and coding in line with CMS and internal policies.

The role includes delivering education sessions for coders and physicians, collaborating with the Compliance team, and staying up to date with evolving regulations and payer guidelines to support compliant revenue practices.