Remote Quality Coding Auditor

UCHealth University of Colorado Health; Denver, Northern (CO, KY); Hybrid; USD 47,000 - 70,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Free Care.com membership

Tuition reimbursement up to $5,250/yr

Job summary

UCHealth is seeking a Professional Coding Specialist to ensure data integrity by reviewing diagnosis and procedure code assignments and validating CPT, ICD-10-CM, and HCPCS designations. This 100% remote role allows eligible out-of-state candidates.

You will conduct internal quality reviews, provide coding education across the Health System, respond to physician queries, and support denial management with thorough rationale for code assignments.

Qualifications

• CPT, ICD-10-CM, HCPCS coding knowledge
• Experience with coding audits and education

Responsibilities

• Conducts internal quality reviews, in accordance with the Coding Compliance Plan. Reviews government, commercial and other external audits. Performs internal audits as requested by other departments. Monitors and reports issues/trends.
• Presents coding education to staff, leadership and others throughout the Health System. Provides training as necessary. Assists with developing and guiding SMEs responsibilities.
• Responds to coding questions submitted throughout the Health System. Reviews physician queries for appropriateness, and related correspondence.
• Reviews coded claims data in response to denials and customer service requests. Provides thorough rationale and explanation for proper code assignments.
• Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.
• Ability to learn and apply coding and auditing expertise to a variety of medical and surgical specialties is a must.

Skills

Evaluation and management coding

Education

High School diploma or GED

AHIMA or AAPC coding certification

Job description

UCHealth is seeking a Professional Coding Specialist to ensure data integrity by reviewing diagnosis and procedure code assignments and validating CPT, ICD-10-CM, and HCPCS designations. This 100% remote role allows eligible out-of-state candidates.

You will conduct internal quality reviews, provide coding education across the Health System, respond to physician queries, and support denial management with thorough rationale for code assignments.