Certified Coder and Auditor

Position Overview

Takes a guiding role in the orientation and ongoing education of professional coding team, physicians, and advanced practice providers (APPs) involved in the coding and documentation process. Ensures the accuracy of information in these processes is maintained by conducting audits and analyzing chart documentation and, if accuracy is not at the expected level, reeducates and trains providers and staff. Serves as knowledge source as it related to coding guidelines; CMS, federal, and state coding regulations; and third party reimbursement requirements. Responsible for converting and auditing documentation of diagnosis, procedures, and utilized supplies and devices for assigned physicians and APPs using ICD-10, CPT, and HCPCS guidelines. Acts as a coding resource for assigned providers and clinic managers. Collaborates with the follow-up team to overturn denials and avoid future denials.

Qualifications

• High School graduate or equivalent
• Professional Coding Certification (CPC, CCS-P)
• At least two (2) years of experience analyzing and providing feedback on physician documentation and performing coding audits
• Fully knowledgeable of, and conducts all activities in accordance with regulatory compliance requirements, including but not limited to HIPPA rules and regulations, Medicare Secondary Payer Screening requirements, medical necessary screening and ABN rules, Red Flag Rules, and billing and coding compliance rules and regulations

Preferred Qualifications

• Certified Professional Medical Auditor (CPMA) and Certified Risk Adjustment Coder certification
• Associate's or bachelor's degree in health administration, health information management, or related field or pursuit of an advances degree
• Previous coding education/training experience
• Previous billing experience and demonstrates knowledge of third party and self-pay billing procedures and claim review and analysis

Benefits

• Collaborative and engaged workplace culture
• Competitive wages and comprehensive benefits
• Generous paid time off (PTO) to support work-life balance
• Health, dental, and vision insurance options
• 403(b) retirement plans with up to 4% employer match
• Paid parental leave
• Pharmacy discounts for employees
• Free on-site parking
• Opportunities for professional growth and internal advancement
• Recognition programs, including the DAISY Nursing Award for excellence