Coding Data Quality Auditor, Analyst

Role Overview

• Responsible for performing quality inter-rater review audits of medical records coded by internal team
• Ensure the ICD-10 codes are appropriate, accurate, and supported by clinical documentation
• Demonstrate proficiency in supporting coding judgment and decisions
• Communicate audit process and results to appropriate departments and management
• Conduct process audits to ensure compliance with internal policies and procedures
• Identify and recommend opportunities for process improvements

Requirements

• CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder) required
• Experience with International Classification of Disease (ICD) codes required.
• Minimum of 3 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing.
• Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) required.
• Computer proficiency including experience with Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook, industry standard coding applications).

Benefits

• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• other resources, based on eligibility