Senior Internal Auditor
Lamb Weston
Medical Coding Auditor, CPC, CCS-P, CPMA
Crossroads
full-time
Posted on:
Location Type: Remote
Location: Remote • South Carolina • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Conducting audits of claims and patient records to identify incorrect coding
- Audits will be performed for both provider and coder coding accuracy with required documentation in accordance with current coding guidelines
- Developing, implementing, and coordinating corrective action proposals and plans
- Tracking completion of internal and external Plans of Correction
- Preparing reports of findings and any compliance issues identified with audits, including monthly summary reports for the Crossroads executive team and quarterly reports for the Chief Compliance Officer
- Attending and reporting at weekly team calls with Manager of Medical Coding Compliance Audits, Director of Medical Coding Compliance and Chief Compliance Officer
- Attending weekly meetings with other auditors
- Reporting coding patterns identified within the audit process to management and identifies corrective measures to compliance problems
- Assisting the Manager of Medical Coding Compliance Audits with training and education of providers, coders, and centers (OBOTs and OTPs) on medical coding compliance
- Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-10 materials, the Federal Register, and other pertinent materials
- May interact with providers and/or center administrators from time to time regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
- Provide coding and compliance updates to all staff
- Collaborates with interdepartmental or cross-functional teams for assigned projects and provides departments with identified coding issues and updates to ensure timely and accurate reimbursement
- Determines method of completing daily workload and priorities to ensure that all responsibilities are carried out in a timely manner
- Assisting with pulling records requested by payers related to payer audits and review of such records to identify any issues
- Other duties and responsibilities pertaining to medical coding compliance monitoring as requested by the Director of Medical Coding Compliance
Requirements
- Certified Professional Coder (CPC), Certified Coding Specialist- Professional (CCS-P) or Certified Professional Medical Auditor (CPMA)
- High School diploma, GED or equivalent
- Minimum of 5 years of coding experience
- Minimum of 2 years of auditing experience
- Experience in auditing healthcare provider documentation to identify correct ICD-10-CM, CPT, and/or HCPCS codes preferred
- An excellent understanding of Mental Health / Opioid Addiction medical terminology preferred
- An excellent understanding of ICD-10-CM coding classification and CPT/HCPCS coding
- Computer literate adept skill level on MS Office applications
- Good organizational and communication skills
- Task oriented and ability to meet designated deadlines and productivity standards
- Strong, well-developed interpersonal skills
- Experience in Mental Health or Addiction Medicine a plus
Benefits
- Medical, Dental, and Vision Insurance
- PTO
- Variety of 401K options including a match program with no vesture period
- Annual Continuing Education Allowance (in related field)
- Life Insurance
- Short/Long Term Disability
- Paid maternity/paternity leave
- Mental Health Day
- Calm subscription for all employees
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
coding accuracyauditingICD-10-CMCPTHCPCSmedical coding compliancecorrective action proposalsreport preparationbilling documentationcoding guidelines
Soft skills
organizational skillscommunication skillsinterpersonal skillstask orientedability to meet deadlinescollaborationtraining and educationproblem identificationreportingprioritization
Certifications
Certified Professional Coder (CPC)Certified Coding Specialist- Professional (CCS-P)Certified Professional Medical Auditor (CPMA)
