Overview
Remote
Depends on Experience
Contract - W2
Skills
CRC
Configuration Management
Change Management
Medical Records
Artificial Intelligence
Auditing
Articulate
Natural Language Processing
Content Management
Documentation
ICD
ICD-10
ICD-9
Productivity
Regulatory Compliance
Job Details
Title: Coding Auditor
Duration: 6+ Months (can extend)
Location: Eagan, MN / Remote
JOB SUMMARY
Coding Auditor
This position is responsible for providing quality assurance and coding audit services for risk adjustment purposes, supporting ACA Commercial, Medicare and Medicaid programs.
Your Responsibilities:
- Reviews patient records in accordance to current compliance policies to analyze provider documentation to ensure that it meets standards and supports the diagnosis and procedure codes selected, including supporting medical necessity severity of illness and risk of mortality
- Conduct audits on abstracted files to ensure accuracy and completeness of coding by identifying accurate coding opportunities and rechecking all diagnoses and procedures using ICD-CM (ICD-9 and ICD-10) and CPT-4 codes to ensure adherence to all official coding guidelines, federal and state regulations, health system and departmental policies and productivity standards.
- Demonstrates an understanding of hierarchical condition categories (HCCs) and participates in quality coding initiatives as appropriate or assigned.
- Ability to articulate
Required Skills and Experiences:
- Assoc degree and 3 yrs relevant health plan or provider office medical coding. In lieu of degree, 5 yrs relevant experience.
- Proficient knowledge of CMS-HCC model and guidelines
- Previous experience in auditing medical records
- Coding Certification required (CRC, RHIA, RHIT or similar) in good standing
- ICD-10 proficient
Preferred Skills and Experiences:
- Bachelor s Degree
- Experience with NLP/AI coding software
- Risk Adjustment methodology experience
- Specialty coding experience
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.