About The Position
As a key member of the Amazon One Medical Revenue Cycle team, the Coding Compliance Auditor will be responsible for supporting Amazon One Medical Clinical and Revenue Cycle teams in managing and optimizing compliant healthcare revenue cycle operations. This role demonstrates increased autonomy and strategic thinking and problem-solving skills, performing detailed reviews of medical coding practices to ensure accuracy, compliance with regulatory requirements, and adherence to organizational policies and procedures. The auditor reports into the Coding Compliance Auditing Manager, Revenue Cycle. The ideal candidate enjoys improving the status quo, identifies and creates necessary processes, interacts comfortably with various teams, and tailors communication to different audiences. They possess a high accountability bar, motivate others, and consistently follow through on commitments.
Requirements
- Associate's degree in related field
- 3+ years of coding/auditing experience in the professional fee and/or risk adjustment setting working with Medicare, Medicare Advantage, and Commercial payers required.
- Knowledge of industry standard code sets and associated guidelines (ICD-10-CM, CPT, HCPCS).
- Possesses advanced knowledge and understanding of HCC Risk Adjustment, coding and documentation requirements.
- CPC certification through AAPC and/or CCS certification through AHIMA required.
- CPMA and CRC certification through AAPC required.
Nice To Haves
- Bachelor's degree in a related field
- Ability to manage projects, and processes leveraging reports and metrics.
- Fluency in G-suite, Excel, and auditing tools.
- Demonstrates ability to identify and communicate trends in coding and documentation.
- Strong written, verbal, communication, and attention to detail skills.
- Strong organizational, analytical, problem solving, and time management skills.
- Adaptable to shifting priorities and demonstrates willingness to do what it takes to meet team needs.
- Complies with policies and procedures for confidentiality of all patient records and security of systems.
- Ability to work independently and meet quality of work and workload expectations.
Responsibilities
- Conduct regular audits to verify accuracy of ICD-10-CM, CPT, HCPCS, and modifier medical codes.
- Review documentation to verify appropriate code assignment.
- Ensure coding reflects clinical documentation and meets medical necessity requirements.
- Identify coding inaccuracies and opportunities for improvement.
- Track and report coding errors and findings.
- Maintain detailed records of audit findings.
- Ensure adherence to coding guidelines and regulatory requirements.
- Follow established policies and procedures, and surfaces and escalates compliance concerns as appropriate.
- Communicate audit findings effectively.
Benefits
- sign-on payments
- restricted stock units (RSUs)
- health insurance (medical, dental, vision, prescription, Basic Life & AD&D insurance and option for Supplemental life plans, EAP, Mental Health Support, Medical Advice Line, Flexible Spending Accounts, Adoption and Surrogacy Reimbursement coverage)
- 401(k) matching
- paid time off
- parental leave
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
