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Medical Coding Auditor @Performant Recovery, Inc.

[Hiring] Medical Coding Auditor @Performant Recovery, Inc.

Apr 04, 2025 - Performant Recovery, Inc. is hiring a remote Medical Coding Auditor. 💸 Salary: $79,300 - $85,000. 📍Location: USA.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

The Medical Coding Auditor-Inpatient is responsible for ensuring the accuracy, integrity, and compliance of medical coding practices within the organization, with a primary focus on Inpatient services. This role involves auditing medical records, coding data, and billing information to verify adherence to coding guidelines and regulations. The Medical Coding Auditor plays a crucial role in minimizing coding errors, preventing fraudulent activities, and ensuring that the organization meets all applicable standards and requirements.

  • Audit Medical Records: Review and audit medical records to ensure accurate coding of diagnoses, procedures, and services using ICD-10, CPT, and HCPCS codes.
  • Compliance Monitoring: Ensure that coding practices comply with federal, state, and payer-specific regulations and guidelines, including HIPAA and CMS standards.
  • Identify and Correct Errors: Detect discrepancies and coding errors, provide feedback, and collaborate with coding staff to correct inaccuracies in medical documentation.
  • Education and Training: Provide training and support to coding staff on best practices, coding updates, and compliance standards. Conduct workshops and seminars as needed.
  • Report Generation: Prepare detailed audit reports that highlight findings, trends, and areas for improvement. Present reports to management and relevant stakeholders.
  • Policy Development: Assist in developing and updating coding policies, procedures, and guidelines to ensure ongoing compliance and efficiency.
  • Collaboration: Work closely with medical billing, compliance, and clinical teams to ensure that coding supports accurate billing and reimbursement processes.
  • Stay Current: Keep abreast of changes in coding regulations, industry trends, and best practices. Participate in continuing education to maintain coding certifications.

Qualifications

  • 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.
  • Strong analytical and problem-solving skills.
  • Excellent attention to detail and accuracy.
  • Effective communication and interpersonal skills.
  • Ability to work independently and as part of a team.
  • Ability to work remotely from a home office without on-site supervision.
  • Proficiency in coding software and electronic health record (EHR) systems.

Requirements

  • High school diploma or equivalent GED required.
  • Associate's or Bachelor's degree in Health Information Management, Medical Coding, or a related field preferred.
  • Active certification is required. Certified Professional Coder (CPC) and/or Certified Coding Specialist (CCS) are preferred, while CPC-H, CPC-P, RHIA, RHIT, or CCS-P are all generally accepted as well.
  • At least three (3) years of direct experience in coding/auditing applicable services, and medical chart review for all provider/claim types.
  • Coding for emergency care, observation, and same day surgery is preferred.
  • Prior auditing experience desirable in either a provider setting, or payer experience in claim processing, edit development, and/or coding and reimbursement policy a plus.

Benefits

  • Medical, dental, vision, and disability coverage options.
  • Life insurance coverage.
  • 401(k) savings plans.
  • Paid family/parental leave.
  • 11 paid holidays per year.
  • Sick time and vacation time off annually.

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Before You Apply
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📍 Be aware of the location restriction for this remote position: USA
‼ Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.
Back to Remote jobs  >   All others
Medical Coding Auditor @Performant Recovery, Inc.
All others
Salary 💸 $79,300 - $85,000
Remote Location
USA
Job Type full-time
Posted Apr 04, 2025
Apply for this position Unlock 54,700 Remote Jobs
️
📍 Be aware of the location restriction for this remote position: USA
‼ Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.
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