Coding Compliance Auditor
About The Position
The Coding Compliance Auditor is a member of the Compliance Office and contributes to the Community Health System’s mission to better the lives of all those we serve. As a Coding Compliance Auditor, you will be responsible for conducting coding and documentation audits to ensure accurate code assignment, appropriate billing, integrity of the medical record, and compliance with federal and state healthcare program requirements. The role requires a highly confident coder who can audit both facility coding and professional fees for partners, as well as audit other coders and physicians.
Requirements
- Associate's Degree in Business, Information Systems, Nursing, Health Care, or a related field required
- Experience performing medical record and billing audits/reviews, including clinical documentation, medical terminology, codes (CPT, HCPCS, ICD-10-CM, and revenue), and reviews for charge and reimbursement accuracy required
- Knowledge of federal, state, and private payer guidelines required
- 5 years of healthcare coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCS, if qualifying with an Associate’s Degree
- 3 years of healthcare coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCS, if qualifying with a Bachelor’s Degree
- CCS - Certified Coding Specialist
- CCS-P - Certified Coding Specialist- Physician-based
- CMAS - Certified Medical Audit Specialist
- CPMA - Certified Professional Medical Auditor
- CPC - Certified Professional Coder
Nice To Haves
- Bachelor's Degree in Business, Information Systems, Nursing, Health Care, or a related field preferred
- Epic experience preferred
- Experience with 3M or Optum is preferred
- Experience completing a formal validation report after completing audits preferred
- RHIA - Registered Health Information Administrator
- RHIT - Registered Health Information Technician
- Two or more certifications preferred
Responsibilities
- Conducting coding and documentation audits to ensure accurate code assignment, appropriate billing, integrity of the medical record, and compliance with federal and state healthcare program requirements.
- Auditing both facility coding and professional fees for partners.
- Auditing other coders and physicians.
Benefits
- Free Continuing Education and certification
- Tuition reimbursement, education programs and scholarships
- Vacation time starts building on Day 1, and builds with your seniority
- Free money toward retirement with a 403(b) and matching contributions
- Great food options with on-demand ordering
- Free parking and electric charging
- Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.
- We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
