Coding Auditor- Remote

Med Metrix•Parsippany-Troy Hills, NJ

1d•Remote

About The Position

The Coding Auditor will be responsible for inpatient and outpatient coding and auditing for various specialties. This role will also be responsible for preparing and presenting audit results. The Coding Auditor will perform coding audits and compliance audits for providers, including physicians and mid-level providers. They will prepare reports of audits and present audits to internal and external parties as needed. This role requires accurate application of appropriate coding and documentation guidelines, including but not limited to, E&M and surgery documentation guidelines, CCI guidelines, CPT/HCPCS coding guidelines, and specialty association guidance. The auditor will provide physician education when necessary, which could include audit findings or edit and denial trending. They will also complete coding audits for copartners’ coding WQ, work with any offsite auditors, and evaluate and report on the overall quality of physician documentation that supports selected codes, most specifically but not inclusive of medical necessity. Adherence to local and national coverage determinations, CCI and payer specific editing rules, and appropriate documentation and coding of split/shared services, teaching physician guidelines and any client specific quality assessment programs are essential. The role involves compiling, trending, analyzing and reporting on all findings that do not meet all of the guidelines listed. Maintaining a professional attitude and completing other duties as assigned by the management team are also part of the responsibilities. The employee must use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards and comply with Information Security and HIPAA policies and procedures at all times, limiting viewing of PHI to the absolute minimum as necessary to perform assigned duties.

Requirements

High School diploma or equivalent required.
CPC or CCS coding certification required from AHIMA or AAPC.
Minimum 5 years of coding experience and minimum 2 years auditing experience in a multi-specialty setting.
Must be able to use job-related software.
Self-starter with ability to work independently.
Proficiency in Microsoft Office Suite.
Strong interpersonal skills, ability to communicate well at all levels of the organization.
Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses.
High level of integrity and dependability with a strong sense of urgency and results oriented.
Excellent written and verbal communication skills required.
Gracious and welcoming personality for customer service interaction.

Responsibilities

Perform coding audits and compliance audits for providers, including physicians and mid-level providers.
Prepare reports of audits and present audits to internal and external parties as needed.
Complete accurate application of appropriate coding and documentation guidelines, including but not limited to, E&M and surgery documentation guidelines, CCI guidelines, CPT/HCPCS coding guidelines, and specialty association guidance.
Provide physician education when necessary. This could include, but is not limited to, audit findings or edit and denial trending.
Complete coding audits for our copartners’ coding WQ.
Work with any offsite auditors.
Evaluate and report on the overall quality of physician documentation that supports selected codes most specifically but not inclusive of medical necessity.
Adhere to local and national coverage determinations, and CCI and payer specific editing rules.
Ensure appropriate documentation and coding of split/shared services, teaching physician guidelines and any client specific quality assessment programs.
Compile, trend, analyze and report on all findings that do not meet all of the guidelines listed above.
Maintain a professional attitude.
Other duties as assigned by the management team.
Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
Understand and comply with Information Security and HIPAA policies and procedures at all times.
Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties.