[Hiring] Coding Auditor @Med-Metrix

Role Description

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.

• 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
  • Specialty association guidance
• Provide physician education when necessary, including 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, specifically regarding medical necessity.
• Adhere to local and national coverage determinations, 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 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 necessary to perform assigned duties.

Qualifications

• 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, 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.

Requirements

• Must possess a smart-phone or electronic device capable of downloading applications for multifactor authentication and security purposes.

Working Conditions

• While performing the duties of this job, the employee is occasionally required to move around the work area; sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals, and telephones; extend arms; kneel; talk and hear.
• The employee must be able to follow directions, collaborate with others, and handle stress.
• The noise level in the work environment is usually minimal.