Medical Coding Auditor, Outpatient
BASF
Job Level
SeniorLead
About the role
- Ventra Health: business solutions provider for facility-based physicians in anesthesia, emergency medicine, hospital medicine, pathology, and radiology.
- Lead and provide guidance to the US medical coding team as US Healthcare Medical Manager, Coding.
- Oversee coding operations ensuring accuracy, completeness, and compliance with CPT, ICD-10, HCPCS and other regulations.
- Implement best practices to optimize coding efficiency and productivity.
- Ensure coding compliance with HIPAA and other privacy and reimbursement regulations.
- Provide ongoing training, mentoring, and professional development for coding staff.
- Collaborate with revenue cycle, clinical documentation improvement, and compliance teams to optimize revenue capture.
- Monitor coding metrics and KPIs; develop reports and communicate trends to senior management.
Requirements
- Bachelor's degree in any related field (Master's preferred).
- Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) required.
- Minimum of 8 years of experience in medical coding.
- At least 3 years in a supervisory or managerial role.
- In-depth knowledge of CPT, ICD-10, HCPCS coding systems and coding guidelines.
- Strong leadership, communication, and interpersonal skills.
- Proficiency in coding software and electronic health record (EHR) systems.
- Experience developing and implementing coding policies, procedures, and quality assurance programs.
- Experience with revenue cycle management processes and healthcare reimbursement methodologies.
- Familiarity with encoders, grouper software, and computer-assisted coding (CAC) systems.
- Knowledge of healthcare compliance regulations, including HIPAA, HITECH, and Medicare billing rules.
