Audit and Coding Specialist

Community Reach Center • Westminster, CO

2d • Hybrid

About The Position

The Audit and Coding Specialist is an integral member of Community Reach Center’s Quality Improvement Division. This role is responsible for managing all aspects of assigned projects, reviewing compliance standards to maintain quality assurance functions, and supporting risk management activities for the agency. The Audit and Coding Specialist will also have other duties and responsibilities as determined from time to time by the Utilization Manager. The position is part of a compassionate community dedicated to providing exceptional mental health outcomes, prioritizing empowering individuals living with mental health conditions, engaging with partners to make a lasting impact, and caring for the team on a personal level. The mission is to enhance community health through evidence-based practices and convenient service locations, ensuring the well-being of consumers and communities. Community Reach Center offers more than just a job – it provides an experience that nurtures personal and professional growth, allowing individuals to gain the skills to pursue their dreams while finding fulfillment within the team. The company prioritizes an exceptional employee experience, knowing it's imperative to prioritize employee needs first so they can be their best selves for the mission served. They are eager to work with passionate, forward-thinking, talented team members.

Requirements

• Bachelor’s Degree or equivalent required.
• Two years minimum experience healthcare auditing or utilization review.
• Certified Professional Coder or Certified Coding Specialist- Physician Based, required.
• Strong professional knowledge of Microsoft Office Suite of Products, including PowerPoint.
• Communication, organization, time management and clinical skills.
• Regular, predictable attendance is required.

Nice To Haves

• Certified Professional Medical Auditor (CPMA) and Certified Documentation Expert Outpatient (CDEO) certifications highly desired.
• Bilingual Spanish preferred.

Responsibilities

• Designs and implements internal compliance audits, regularly monitoring accuracy and adherence to documentation requirements in collaboration with Utilization Manager to support continuous quality improvement and compliance as identified in the Quality Management Plan (QMP).
• Conducts audits as determined by the Manager or Director.
• Oversees preparation and participates in response to external audits to ensure appropriate access to authorized protected health information (PHI) and coordinating with Program Managers and other Managers and Directors to address and monitor corrective action needs.
• Collaborates with Utilization Manager and QI Manager to implement, track, and monitor client outcomes to identify opportunities for continuous quality improvement.
• Maintains knowledge of current Colorado State laws, rules, and policies around mental health licensure and a working knowledge of current clinical practices.
• Maintains knowledge of and certifications for Certified Professional Coder (CPC) or Certified Coding Specialist Physician Based (CCSP).
• Creates, communicates and implements templates, systems and processes to ensure clinical documentation at the Center is in accordance with internal policies and procedures, Centers for Medicare and Medicaid Services (CMS), State and Federal regulations, third-party payors, and American Medical Association (AMA) guidelines.

Benefits

• Competitive compensation
• 401K with matching
• Wellness Program
• Health Insurance Reimbursement Allocation
• Medical, dental, and vision insurance
• Internal Opportunities & Free trainings
• Shift differential pay when applicable
• Bilingual stipend pay
• 24/7 Employee Assistance Program to support mental health and a balanced lifestyle
• Opportunity for cross-licensure sponsorship if eligible & applicable
• Healthy Work Life Balance
• Excellent PTO & Paid Holiday
• Tuition Reimbursement
• Loan Forgiveness options including National Heath Service Corps, Colorado Health Service Corps and Public Student Loan Forgiveness.
• Mileage reimbursement opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level