Senior Medical Coding Auditor — Quality & Compliance

McLaren Health Care Corporation; Grand Blanc (MI); On-site; USD 90,000 - 120,000; Full time

Job summary

McLaren Health Care Corporation seeks a Senior Medical Coding Auditor to guide ongoing coding education for physicians, coders, and CDI staff and to ensure accurate code assignment. You will audit inpatient and outpatient coding, validate POA indicators and support clinical validation initiatives with CDI.

Experience includes 3 years in medical coding audits, familiarity with MS-DRG/APC systems, and related certifications such as RHIA/RHIT/CCS or CPC/CIRCC/ROCC.

Qualifications

• AHIMA Certification such as RHIA, RHIT or CCS.
• AAPC Certification such as CPC, CCC, COC, CIC, CHONC, etc.
• AMAC Certification such as ROCC (Radiation Oncology Certified Coder).
• 3 years’ experience conducting medical coding audits and quality performance measures.

Responsibilities

• Completes quality assurance audits on inpatient and outpatient coding specialists, onboarding audits and training of newly hired coding specialists.
• Validates POA indicators and identifies missing or inappropriate queries to providers.
• Uses payment methodology to audit MS-DRG or APC assignment and OPPS reimbursement; develops guides with CDI.
• Serves as advisor and support to the Auditor.
• Performs retrospective, random, and focused audits to ensure accurate code application.
• Performs ongoing pre-bill compliance audits to ensure coding guidelines compliance.

Skills

Quality auditing

Medical coding

Education

RHIA/RHIT/CCS Certification

CPC/CCC/COC/CIC/CHONC Certification

AMAC ROCC Certification

Associate degree in HIT / Applied Science / Liberal Arts or related healthcare field

Job description

McLaren Health Care Corporation seeks a Senior Medical Coding Auditor to guide ongoing coding education for physicians, coders, and CDI staff and to ensure accurate code assignment. You will audit inpatient and outpatient coding, validate POA indicators and support clinical validation initiatives with CDI.

Experience includes 3 years in medical coding audits, familiarity with MS-DRG/APC systems, and related certifications such as RHIA/RHIT/CCS or CPC/CIRCC/ROCC.