Coding Auditor

Health Ministries Clinic • Newton, KS

10h • Onsite

About The Position

Health Ministries Clinic (HMC) is seeking a Coding Auditor (with PCP auditing experience) as a trusted expert to join our integrated care team in Newton, Kansas. This is a full-time, on-site position offering the opportunity to support patient care in a collaborative, mission-driven environment. At Health Ministries Clinic, we offer more than just primary care with a full spectrum of services including behavioral health, lab, diagnostic, pharmaceutical and dental . We are seeking an experienced Coding Auditor with a multi- speciality coding background . The Coding Quality Auditor is responsible to ensure Health Ministries Clinic's compliance with national coding guidelines, FQHC coding guidelines and regulations . The Coding Auditor plays a crucial role in minimizing coding errors and preventing fraudulent activities . The Coding Auditor is responsible to ensure accurate and consistent coding which results in appropriate reimbursement and data integrity . This role requires the ability to detect and correct discrepancies and coding errors, provide feedback and collaborate across departments to correct inaccuracies in medical documentation .

Requirements

• Extensive knowledge of ICD-10, CPT, and HCPCS coding systems
• Familiarity with healthcare regulations, including HIPAA, CMS guidelines, and payer-specific requirements
• Understanding of medical terminology, anatomy, and physiology
• Maintains up-to-date knowledge of medical coding guidelines, regulatory changes and industry best practices
• Maintains active coding certification
• Strong analytical and problem-solving skills
• Excellent attention to detail and accuracy , thorough
• Effective communication and interpersonal skills , people-oriented
• Effective time management
• Able to follow directions and work independently
• Proficiency with EHR systems, billing software, and Microsoft Office (Outlook, Word, Excel)
• High school diploma or equivalent GED
• Minimum of three (3) years of direct experience in coding/auditing applicable services, and medical chart review for all provider/claim types.

Nice To Haves

• Active certification is in one or more of the following, preferred: Certified Professional Coder (CPC) , Certified Coding Specialist (CCS) , Certified Professional Medical Auditor ( CPMA ), Auditing Outpatient Coding (OAC)

Responsibilities

• Reviews designated claims for proper coding before submission
• Corrects any errors or discrepancies
• Assist s Billing Specialists with coding-related questions during billing processes
• Work s coding-related denials
• Work s closely with providers to clarify documentation and improve coding accuracy
• Responds promptly to manager requests to code or review coded accounts for accuracy
• Provides assistance to the leadership team and management with coding of the accounts or answering questions related to coding and workflows
• Understand s payor rules , medical policy guidelines and documentation requirements (commercial and government) that affect coding
• Ensure s coding compliance with AMA, CMS guidelines, and state/federal regulations
• Meet s coding productivity and quality standards
• Reviews provider medical records and audits to ensure accurate coding of diagnoses, procedures and services using ICD-10, CPT and HCPCS codes
• Prepare s detailed audit reports that highlight findings, trends and areas for improvement
• Present s findings to management and relevant stakeholders
• Effectively interacts and communicates findings with providers.
• Able to communicate why a code is incorrect, what the correct code should be and why the new code is to be used
• Able to communicate what changes in documentation habits needed to make accurate coding selection
• Ensure coding compliance with AMA, CMS guidelines, and state/federal regulations
• Participates in special reviews or projects, as assigned
• Provide new hire training for onboarding providers
• Provide on-going support and education to providers
• Provide education / training to Billing Specialists
• Participate and provide good coding feedback during meetings, education and trainings
• Takes initiative to assist others and share knowledge on official coding guidelines

Benefits

• Set schedule
• Medical, dental, and vision insurance
• Retirement plan with employer contributions
• Paid time off and holidays
• Competitive salary
• Supportive team environment with dedicated administrative and clinical staff

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED