Medical Coding Auditor

Role Overview

• The Medical Coding Auditor extracts clinical information from medical records and assigns appropriate procedural terminology and medical codes
• audits medical charts and records for compliance
• provide a second level review of codes assigned to medical diagnoses and clinical procedures
• prepare written summaries of audit findings
• present verbal audit feedback and provide education upon completion of the medical record audit
• respond to or clarify internal requests for information
• support and participate in process and quality improvement projects
• partner with business associates from other departments to understand their needs and concerns, and help develop system solutions

Requirements

• This position requires both a CPMA AND CRC and it also requires at least ONE of the certifications from AAPC or AHIMA
• CPC
• Certified Professional Coder (AAPC)
• CCS
• Certified Coding Specialist (AHIMA)
• CCS-P
• Certified Coding Specialist-Physician Based (AHIMA)
• 2 or more years of outpatient coding experience (Preferably in a risk adjustment setting)
• Knowledge of several reimbursement methodologies, including risk adjustment and fee for service
• Must maintain annual continuing education requirements and remain in good standing with the certification governing body
• Proficient in all Microsoft Office applications, including Word and Excel
• Public speaking / group presentation skills
• Ability to travel locally and overnight within Conviva and CenterWell markets per business need

Benefits

• medical, dental and vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance