Medical Coding Auditor – Outpatient, OIG Focus
BASF
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $61,300 - $71,000 per year
About the role
- Audit Medical Records: Review and audit medical records to ensure accurate coding of diagnoses, procedures, and services using ICD-10, CPT, and HCPCS codes
- Compliance Monitoring: Ensure that coding practices comply with federal, state, and payer-specific regulations and guidelines, including HIPAA and CMS standards
- Identify and Correct Errors: Detect discrepancies and coding errors, provide feedback, and collaborate with coding staff to correct inaccuracies in medical documentation
- Education and Training: Provide training and support to coding staff on best practices, coding updates, and compliance standards. Conduct workshops and seminars as needed
- Report Generation: Prepare detailed audit reports that highlight findings, trends, and areas for improvement. Present reports to management and relevant stakeholders
- Policy Development: Assist in developing and updating coding policies, procedures, and guidelines to ensure ongoing compliance and efficiency
- Collaboration: Work closely with medical billing, compliance, and clinical teams to ensure that coding supports accurate billing and reimbursement processes
- Stay Current: Keep abreast of changes in coding regulations, industry trends, and best practices. Participate in continuing education to maintain coding certifications
Requirements
- High school diploma or equivalent GED required
- Associate's or Bachelor's degree in Health Information Management, Medical Coding, or a related field preferred
- Active certification is required
- Certified Professional Coder (CPC) and/or Certified Coding Specialist (CCS) are preferred, while CPC-H, CPC-P, RHIA, RHIT, or CCS-P are all generally accepted as well
- At least three (3) years of direct experience in coding/auditing applicable services, and medical chart review for all provider/claim types
- Coding for emergency care, observation, and same day surgery is preferred
- Prior auditing experience desirable in either a provider setting, or payer experience in claim processing, edit development, and/or coding and reimbursement policy a plus.
Benefits
- medical, dental, vision
- HSA/FSA options
- life insurance coverage
- 401(k) savings plans
- family/parental leave
- paid holidays
- paid time off annually
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
ICD-10CPTHCPCSmedical codingauditingerror detectionreport generationpolicy developmentcompliance monitoringmedical chart review
Soft skills
collaborationcommunicationtrainingfeedbackpresentationorganizational skillsattention to detailproblem-solvingadaptabilityleadership
Certifications
Certified Professional Coder (CPC)Certified Coding Specialist (CCS)CPC-HCPC-PRegistered Health Information Administrator (RHIA)Registered Health Information Technician (RHIT)Certified Coding Specialist - Physician-based (CCS-P)