Coding Data Quality Auditor, Analyst

Role Overview

• Responsible for performing quality inter-rater review audits of medical records coded by internal team
• Leads dispute resolution
• Acts as mentor to provide education to internal staff based on audit findings
• Conducts process audits to ensure compliance with internal policies and procedures and existing CMS regulations
• Identifies and recommends opportunities for process improvements
• Adhere to stringent timelines consistent with project deadlines and directives

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

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility