Senior Medical Auditor: Compliance & Coding Expert

Hirebridge; Buffalo (NY); Sur place; USD 70 000 - 100 000; Plein temps

Avantages offerts par ce poste

Flexible spending account (FSA)

Health insurance

Life insurance

Paid time off

Parental leave

Retirement plan

Résumé du poste

Hirebridge is seeking a Certified Medical Auditor to lead comprehensive medical record, coding, billing, and compliance audits in our Buffalo, NY team. You will review ICD-10-CM, CPT, HCPCS data and collaborate with coding, clinical, billing, and leadership staff.

This role requires CMA certification, meticulous audit workpapers, and the ability to educate staff on documentation improvements while staying current with CMS and payer requirements.

Qualifications

• Certification as CMA or equivalent auditing certification.
• Strong knowledge of medical coding, documentation, billing, and reimbursement principles.
• Knowledge of ICD-10-CM, CPT, HCPCS and coding guidelines.

Responsabilités

• Conduct prospective, concurrent, and retrospective medical record and coding audits.
• Review medical documentation to validate accuracy of ICD-10-CM, CPT, HCPCS data.
• Evaluate medical necessity, documentation requirements, code assignment, and billing practices.
• Identify coding errors, documentation deficiencies, compliance risks, and billing discrepancies.
• Prepare audit findings and detailed reports with recommendations and corrective actions.

Connaissances

Certified Medical Auditor

Medical coding knowledge

ICD-10-CM CPT HCPCS

CMS Medicare/Medicaid rules

Analytical skills

Communication skills

Team collaboration

Attention to detail

Microsoft Excel

Microsoft Word

Formation

Bachelor’s or Associate degree in HIM/Health Info or related field

RHIA/RHIT/CPMA/CEMA/CPC or similar HIM certification

Outils

Excel

Word

Description du poste

Hirebridge is seeking a Certified Medical Auditor to lead comprehensive medical record, coding, billing, and compliance audits in our Buffalo, NY team. You will review ICD-10-CM, CPT, HCPCS data and collaborate with coding, clinical, billing, and leadership staff.

This role requires CMA certification, meticulous audit workpapers, and the ability to educate staff on documentation improvements while staying current with CMS and payer requirements.