Medical Coding Auditor

Profile

Description

The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Medical Coding Auditor:


Verifies and ensures the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions
Confirms appropriate diagnosis and procedure code assignment, in accordance with all applicable coding guidelines
Utilizes electronic tools (i.e., spreadsheets) that have been created based on the CMS-HCC model and established coding guidelines
Prepares written summaries of audit findings
Presents verbal audit feedback and provides education upon completion of the medical record audit
Responds to or clarifies internal requests for information
Supports and participates in process and quality improvement initiatives
Partners with business associates from other departments to understand their needs and concerns, and participate in the development of system solutions
Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas
Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
Follows established guidelines/procedures
Assists in other coding capacities as needed


Required Qualifications


CPC, CCS, or CCS-P AND CPMA AND CRC
Outpatient coding experience, preferably in a risk adjustment setting
Passionate about contributing to an organization focused on continuous improvement
Proficient verbal and written communication skills
Proficient in all Microsoft Office applications, including Word and Excel
Public speaking / group presentation skills
Ability to travel locally and overnight within the state of Florida and/or Texas


Preferred Qualification


CDEO
Bachelor's Degree
Outpatient auditing experience, preferably in a risk adjustment setting


Other Notes


Works from a corporate office or WAH, depending on the markets and locations assigned
May require travel within the assigned market or to corporate offices


Scheduled Weekly Hours

40

Company info

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