Coding Compliance Audit Specialist

About the role

The Coding Compliance Audit Specialist conducts audits to ensure accurate coding practices in accordance with CMS and Medicare guidelines.

Responsibilities

• Conduct baseline, routine, and focused audits by comparing medical record documentation to reported CPT, HCPCS, and ICD-10-CM codes.
• Research, interpret, and communicate federal and state laws and guidelines pertaining to CMS and Medicare.
• Act as an internal expert on coding issues to ensure compliance with state and federal regulations.
• Perform other duties as assigned.

Qualifications

• 5+ years of audit experience is preferred.
• Extensive knowledge of CPT, ICD-10, and HCPCS codes and guidelines.
• Certified Professional Coder (CPC) required and Certified Professional Medical Auditor (CPMA).
• Experience working with MDAudit and Athena is a plus.
• Must comply with all HIPAA rules and regulations.
• Excellent communication skills and the ability to work independently.

Skills

• Strong knowledge of CMS and Medicare guidelines.
• Ability to interpret and communicate federal and state regulations.

Benefits

• Base pay range: $70,000.00 to $80,000.00 in base pay and exclusive of any bonuses or benefits.
• Annual bonus targeted at 10% and restricted.
• Medical, dental, vision, life, and pet insurance.
• 401K.
• Paid time off.
• Other wellness programs.

Pay

$70,000.00 to $80,000.00 in base pay and exclusive of any bonuses or benefits.

Schedule

Remote work only. Minimum 5 MBPS download speed and 3 MBPS upload speed required.