Outpatient Coding Auditor- Remote

About the role

We are seeking a talented individual for a Senior Associate position as an Outpatient Coding Auditor. This role involves performing coding reviews of medical records and other documentation to determine correct coding as defined by review methodologies specific to the contract. Responsibilities include accessing proprietary systems to audit medical records, accurately documenting findings, and providing policy/regulatory support for determinations. The candidate must have an extensive background in outpatient coding edits and a high level of understanding of reimbursement guidelines, specifically EAPG, ASC, and APC payment systems.

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, including daily monitoring, mentoring, feedback, and education.
• Maintains current knowledge of coding guidelines and successfully completes required CEUs to maintain coding certification.
• Attends 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 of outpatient medical record coding and/or auditing experience; 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, including Microsoft Windows, Outlook, Excel, Word, PowerPoint, Internet browsers, and virtual meeting tools such as Microsoft Teams and Zoom.

Benefits

• Benefits on the first day of employment.
• Generous, flexible vacation policy.
• 401(k) employer match.
• Comprehensive health benefits.
• Educational assistance.
• Leadership and technical development academies to build skills and capabilities.

Pay

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

Schedule

Remote (work from home) environment within the United States.