Remote Coding Compliance Auditor

Duke Clinical Research Institute; Durham (NC); Remote; USD 70,000 - 110,000; Full time

Benefits offered by this job

Sign-on bonus

Remote work

Job summary

Duke Health seeks a Compliance Specialist Auditor to perform coding quality audits of inpatient records per CMS guidelines, supporting PB coders and ensuring accurate code assignments.

This 100% remote role requires CPC/RHIT/RHIA/CCS credentials, 4 years coding review experience, and knowledge of ICD-10-CM and CPT/HCPCS. A $10,000 sign-on bonus is offered and candidates must reside in one of the listed states.

Qualifications

• 4 years of coding review experience applying compliance, auditing and coding principles in professional coding and billing.
• Certification requirements for CPC/RHIT/RHIA/CCS are required; CRC/CPMA are bonuses.
• Knowledge of ICD-10-CM and CPT/HCPCS guidelines for outpatient diagnoses and procedures.

Responsibilities

• Monthly QA Audits of PB coders to ensure data quality and reimbursement.
• Perform retrospective quality audits for accurate coding of ICD-10-CM diagnoses and CPT-4 procedures.
• Review medical records to ensure documentation supports assigned codes.
• Act as subject matter coding expert and collaborate with outside departments.
• Identify coding and billing risk areas and report results for action plans.
• Analyze coding trends and ensure compliance with federal, state and insurer rules.
• Communicate findings clearly and professionally.
• Conduct additional duties as assigned.

Skills

HCC coding

Multi-Specialty Coding

Interventional Radiology

Cardiothoracic

Ortho (Foot and Ankle)

Critical Care

Observation Services

ED

Edits/Denials

Gen Surg

Trauma

Peds

GI

Anesthesia

Good work ethic

Strong sense of responsibility

Ability to work independently

Education

Certified Professional Coder (CPC)

Registered Health Information Technician (RHIT)

Registered Health Information Administrator (RHIA)

Certified Coding Specialist (CCS)

Certified Risk Coder (CRC)

CPMA

Tools

MS Office (Word, Excel, Visio, Access, PowerPoint)

Epic experience

3M 360 CAC

Audit Manager

Job description

Duke Health seeks a Compliance Specialist Auditor to perform coding quality audits of inpatient records per CMS guidelines, supporting PB coders and ensuring accurate code assignments.

This 100% remote role requires CPC/RHIT/RHIA/CCS credentials, 4 years coding review experience, and knowledge of ICD-10-CM and CPT/HCPCS. A $10,000 sign-on bonus is offered and candidates must reside in one of the listed states.