Remote Medical Coding & Records Auditor

American Health Communities; Franklin (TN); Hybrid; USD 65,000 - 90,000; Full time

Job summary

American Health Communities is seeking a Coding and Medical Records Auditor for a remote role in the United States. You will review claims before submission to ensure accurate ICD-10 coding and may perform post-payment reviews with education to providers.

You will analyze coding trends, ensure CMS guidelines are followed, and coordinate with claim processors to resolve issues while maintaining quality and productivity standards.

Qualifications

• 3 years HCC coding and/or coding and billing required.
• 5 years HCC coding and/or coding and billing preferred.
• 2+ years complex claims processing or coding auditing experience.
• Knowledge of CPT4, ICD10, HCPCS and CMS rules regarding claims.

Responsibilities

• Review claims prior to billing to ensure accuracy.
• Assess trends and educate staff and organization on findings.
• Review medical records to verify diagnosis codes based on services rendered.
• Conduct pre-claim and post-claim coding audits to minimize denials.
• Work with claim processors to correct errors before final payment.

Skills

HCC coding

Coding audits

Claims processing

CMS requirements

Medical records review

Job description

American Health Communities is seeking a Coding and Medical Records Auditor for a remote role in the United States. You will review claims before submission to ensure accurate ICD-10 coding and may perform post-payment reviews with education to providers.

You will analyze coding trends, ensure CMS guidelines are followed, and coordinate with claim processors to resolve issues while maintaining quality and productivity standards.