Medical Coding Auditor - Must have a NM Residence

About the role

This opportunity is a REMOTE, full-time, day shift opening located in Albuquerque, New Mexico. This is a work from home position that requires the selected candidate to have a permanent address and live in New Mexico or be willing to relocate to New Mexico.

Responsibilities

• Audits medical charts and records for compliance with federal coding regulations and guidelines.
• Uses knowledge of UNM Medical Group billing systems procedures to provide a review of evaluation and management codes, medical diagnoses and clinical procedures ensuring that accurate medical billing conforms with legal and regulatory requirements.
• Trains, instructs and provides technical support to medical providers, support staff and medical coding personnel on accurate documentation supports billing and coding standards.
• Collaborates with hospital compliance and coding staff to ensure consistent training with medical providers on professional and facility services.
• Reviews, develops, and/or modifies procedures, systems and protocols to achieve and maintain compatibility with UNM Medical Group billing requirements and compliance standards.
• Assists management with the development of the annual work plan risk assessment and evaluates external payer record requests for reconsideration, appeals and rebuttals.

Requirements

• High School diploma or GED with 5 years directly related experience; at least one of the following CPC, CCs, CCS-P, COC, RHIA or RHIT, CHONC. Certification or certificate eligible for Certified Professional Medical Auditor (CPMA).
• Completed degree from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis.

Qualifications

• Holds a Certified Professional Medical Auditor (CPMA) designation at the time of hire, or secures such designation within 18 months of hire.
• Verifies education and licensure will be required if selected for hire.

Skills

• Extensive knowledge and experience with E/M coding.
• Ability to research, analyze and respond to internal and external inquiries regarding compliance, inappropriate coding, denials and billable services.
• Strong communication and interpersonal skills to interact with physicians, other patient care providers, support staff and coding personnel.
• Ability to train, instruct and provide technical support to medical providers, support staff and coding personnel.
• Knowledge of UNM Medical Group billing systems and procedures.
• Ability to develop, modify and adapt relevant client procedures, protocols and data management systems.

Benefits

• Competitive Salary & Benefits
• Includes medical, dental, vision, and life insurance
• Tuition reimbursement
• Generous paid time off
• 403b retirement plan for eligible employees