Remote Medical Coding Auditor for Compliance & Accuracy

Walt Disney; Honolulu (HI); Vor Ort; USD 50.979 - 79.350; Vollzeit

Benefits dieser Stelle

Health insurance

Zusammenfassung

Walt Disney is seeking an experienced Auditor to review medical records, coding, and billing practices, ensuring compliance with industry standards. The role requires expertise in medical office procedures, coding systems, and terminology to conduct thorough audits.

Responsibilities include audits of claims, reporting findings, and providing education to staff. Remote/hybrid work options may be available; prior HIM coding leadership interaction is valued.

Qualifikationen

• Bachelor's degree in Health Information Management or related field
• CCS certification (preferred)
• Minimum of 2 years of experience in medical coding or auditing
• Proficient in ICD-10 coding and medical terminology
• Knowledge of ICD-9 coding is a plus
• Familiarity with medical collection processes and procedures
• Strong analytical skills with the ability to identify patterns and trends
• Excellent attention to detail and accuracy
• Ability to work independently and meet deadlines

Aufgaben

• Review medical records, coding, and billing documentation to identify discrepancies or errors.
• Conduct audits of medical claims to ensure compliance with coding guidelines and regulations.
• Analyze coding practices to identify potential areas of improvement or risk.
• Verify the accuracy of diagnosis codes (ICD‑10) and procedure codes (DRG).
• Ensure proper documentation of medical services provided.
• Collaborate with healthcare providers and staff to address audit findings and implement corrective actions.
• Stay updated on changes in coding guidelines, regulations, and industry best practices.
• Prepare detailed audit reports with findings and recommendations.
• Review documentation to ensure proper code assignment based on diagnosis, procedures, and services rendered.
• Verify that coding practices comply with current coding guidelines, regulations, and industry standards.
• Identify coding errors, discrepancies, and potential compliance issues through comprehensive review and analysis.
• Ensure timely completion of monthly audit reviews as established by HIM Coding Leadership.
• Provide feedback and education to coding staff and healthcare providers on coding guidelines, documentation requirements, and compliance issues.
• Perform special audits/chart reviews and provide written findings to the requested HIM Coding Leader.
• Develop and implement best practices and training programs to improve coding accuracy and compliance.
• Stay abreast of updates and changes in coding regulations, reimbursement policies, and healthcare industry trends.
• Generate reports and metrics to track coding audit findings, trends, and compliance metrics.
• Report/record all documentation and coding issues that require follow‑up reviews to the coding manager.
• Maintain confidentiality and adhere to ethical standards in handling sensitive patient information.
• Balance team and individual responsibilities; be open and objective to others’ views; give and welcome feedback; contribute to positive team goals; and put the success of the team above personal interests.

Kenntnisse

Analytical skills

Attention to detail

Independent work

Meeting deadlines

ICD-10 coding

ICD-9 knowledge

Ausbildung

Bachelor's degree in Health Information Management or related field

Certified Coding Specialist (CCS) certification

Jobbeschreibung

Walt Disney is seeking an experienced Auditor to review medical records, coding, and billing practices, ensuring compliance with industry standards. The role requires expertise in medical office procedures, coding systems, and terminology to conduct thorough audits.

Responsibilities include audits of claims, reporting findings, and providing education to staff. Remote/hybrid work options may be available; prior HIM coding leadership interaction is valued.