Coding Investigator Auditor

Role Overview

• Responsible for conducting billing, coding, and documentation reviews of professional and outpatient claims
• Validate the accuracy and adherence to ICD-10-CM, CPT, HCPCS and CMS coding guidelines
• Conduct research, preparing documentation and communication of findings
• Consult with internal departments and staff as needed

Requirements

• Bachelor’s Degree; in lieu of degree one year of claims or coding experience, may substitute for each year of college
• Certified Coding Certification (CPC, COC, CCS, CCS-P, RHIT, RHIA) or acquire within 24 months of hire
• 3 years’ experience in claims processing operations and reporting systems, including 2 years’ experience in auditing, or developing computer system reports
• Adhere to time management, production and quality standards as set by the department
• Professional communication skills, oral and written
• Industry knowledge of Medicare regulations and payment policies, including OPPS
• Proficient in computer applications such as Microsoft Excel, Teams, PowerPoint, Word, and Outlook

Benefits

• health and wellness benefits
• 401(k) savings plan
• pension plan
• paid time off
• paid parental leave
• disability insurance
• supplemental life insurance
• employee assistance program
• paid holidays
• tuition reimbursement
• other incentives