Remote Facility Coding Auditor

CorroHealth; Fulton (MS); Remote; USD 70,000 - 100,000; Full time

Job summary

CorroHealth is seeking a Facility Outpatient Coding Quality Specialist (Auditor) for a remote role open to candidates in the United States. You will perform retrospective analyses of medical records to identify coding and billing errors, provide second-level code reviews, and support compliance with AHIMA/CMS guidelines.

The role requires strong communication, coding credentials, and the ability to work independently.

Qualifications

• Performs retrospective analysis of medical records to identify coding/billing errors per guidelines.
• Analyzes audit findings to identify root causes and prevent recurrence.
• Provides second-level review of codes to ensure compliance and optimal reimbursement.
• Researches inquiries regarding compliance, inappropriate coding, denials and billable services.
• Maintains professional coding credentials and knowledge through ongoing education.

Responsibilities

• Perform complex retrospective analysis of medical records to identify coding and billing errors.
• Analyze audit findings to identify root causes and prevent recurrence.
• Provide second-level review of diagnosis, procedure and billing codes for compliance and reimbursements.
• Respond to inquiries regarding compliance, inappropriate coding, denials and billable services.
• Provide training and feedback to internal coding staff on coding compliance and regulations.
• Follow AHIMA Standards of Ethical Coding and the company ethics.
• Prioritize workload and meet deadlines while maintaining accuracy.
• Maintain knowledge of coding guidelines and reimbursement methodologies.
• Ensure privacy and security of patient information.
• Work remotely with minimal supervision.

Skills

Strong communication skills

MS Word

MS Excel

Ability to work with minimal supervisi

Customer service

Prioritization

Education

AHIMA/AAPC credential

CPC or CCS certification preferred

Tools

EMR systems

Job description

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.

We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

Facility Outpatient Coding Quality Specialist (Auditor)

This is a REMOTE position. Must live in the United States. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

• Performs complex retrospective analysis of medical record documentation to identify coding and billing errors and inconsistencies according to guidelines of the AHA, CMS, AMA, Clinic Coding Clinic and CPT Assistant.
• Analyzes audit findings to identify potential root causes of coding errors and prevent their reoccurrence
• Provides second –level review of diagnosis, procedure and billing codes to ensure compliance with legal and procedural policies that ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices.
• Research, analyze and respond to inquiries regarding compliance, inappropriate coding, denials and billable services
• Provides technical support and feedback training to internal coding staff regarding coding compliance, documentation, regulatory provisions, third part payer requirements, medical necessity requirements
• Follows the Standards of Ethical Coding as set forth by AHIMA and adheres to official coding guidelines and compliance practices.
• Provide schedule of planned work activities, events and sites, and any changes to same to management and appropriate staff.
• Maintenance of professional coding credentials and knowledge of coding, reimbursement methodologies and compliance issues through education Monitor the on-going progress and success of each coder
• Maintain QA percentages within two internal quality goals; Identify and resolve coding quality problems or issues in a timely manner
• Maintain a continual knowledge of problems or issues that could affect coding quality levels
• Assist in design of systems to help improve coder productivity and assist in improving accuracy of coding
• Participate in corporate training and meetings
• Align conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct and support the Company’s Ethics and Compliance Program
• Interpret coding guidelines for accurate code assignment
• Identify the importance of documentation on code assignment and the subsequent reimbursement impact
• Comply with all internal policies and procedures
• Actively participate in Company provided training and education
• Ensure individual compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health Information
• Facility IP/OP auditing and coding experience
• Ability to prioritize workload, meet deadlines and maintain a high level of quality and accuracy
• Must have a recognized coding credential from AHIMA or AAPC; Experience with telecommuting and electronic medical records systems strongly preferred
• Ability to work with multiple and diverse clients and projects
• Ability to work with minimal supervision
• Minimum 2 years (Preferrably 3 years) experience coding and/or auditing for Inpatient and Outpatient facilities.
• Customer service support -- minimum one (1) year experience
• Familiarity with hospital outpatient billing processes
• Understand hospital APC assignment and associated coding and documentation
• Coding Certification -- preferred (CPC or CCS)
• Strong communication skills, proficient in Microsoft Office applications including Word and Excel

Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs.