Auditor

• Plan and perform medical record audits to determine coding accuracy and compliant claims submission
• Develop coding and documentation audit methodology using knowledge of key risk areas in coding and documentation compliance
• Perform coding and documentation audits, reviewing medical records and charges to ensure compliance with CPT-4/HCPCS and ICD-10-CM coding guidelines and standards, as well as the Centers for Medicare & Medicaid Services (CMS) coverage guidelines
• Conduct analysis of audit findings to identify trends/problems in coding and documentation and effectively communicates the audit findings and recommended areas for improvement
• Serve as a subject matter expert on interpretation and application of coding and documentation guidelines
• Monitor relevant resources, publications, and current government compliance and enforcement activity related to high-risk compliance areas
• Stay current on coding guidelines
• Develop analyses using transactional data and/or financial data
• Generate client deliverables and make valuable contributions to expert reports
• Manage client relationships and communicate results and work product as appropriate
• Manage junior staff and delegate assignments as directed by more senior managers
• Demonstrate creativity and efficient use of relevant software tools and analytical methods to develop solutions
• Participate in group practice meetings, contribute to business development initiatives and office functions such as staff training and recruiting
• Prioritize assignments and responsibilities to meet goals and deadlines

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