Outpatient Coding Auditor

About the role

We are seeking a talented individual for an Outpatient Coding Auditor, Senior Associate. This role involves performing coding reviews of medical records and/or other documentation to determine correct coding as defined by review methodologies specific to the contract for which review services are being provided.

Responsibilities

• Performs audits of medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCC & CC) and procedure codes.
• Adheres to official coding guidelines, coding clinics and regulatory guidelines and mandates.
• Draws on advanced ICD-10 coding expertise to substantiate conclusions.
• Utilizes proprietary auditing systems with a high level of proficiency to document audit determinations and rationale.
• Consistently achieves productivity and quality performance standards established by management.
• Actively cross-trains to perform reviews of multiple claim types to provide a flexible workforce to meet client needs.
• Assists management with training new Coding Auditors to include daily monitoring, mentoring, feedback and education.
• Maintains current knowledge of coding guidelines and successfully completes required CEUs to maintain coding certification.
• Responsible for attending training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.

Requirements

• One or more active professional credentials through AHIMA or AAPC: CPC, COC, CCS, RHIA, RHIT; required
• 2+ years experience of outpatient medical record coding and/or auditing; required
• Demonstrated proficiency in medical record auditing and ICD-10 CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodology.
• Demonstrated proficiency in computer skills and typing, i.e., Microsoft Windows, Outlook, Excel, Word, PowerPoint, Internet browsers and in virtual meeting tools i.e., Microsoft Teams, Zoom, etc.

Qualifications

The ideal candidate should have a strong background in outpatient coding edits and a high level of understanding in reimbursement guidelines, particularly in the areas of EAPG, ASC, and APC payment systems.

Skills

Advanced ICD-10 coding expertise, proficiency in auditing systems, and strong computer skills are essential for success in this role.

Benefits

Benefits on first day of employment, clear path to advancement with training and leadership, remote (work from home) environment within the United States.

Pay

The pay range for this position is $70,000.00 - $80,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.