Medical Coding Auditor

Job Description:

• Responsible for analyzing, reviewing and providing feedback reputed company performing quality assurance activities and completing QA audits, including but not limited to: Ensuring reputed company federal and state coding guidelines and regulations are met as well as payer guidelines
• Provide effective feedback to the global coding teams to aid in their successful coding of BOOST clients
• Maintaining a communication log to show successful training of the global coding team reputed company coding trends or issues are reputed company
• Report reputed company coding trends and issues to the department reputed company as they are identified
• Review reputed company cases per month based on the reputed company Quality Assurance SOP
• Accurately document their daily audit results in the Daily Audit Log and communicate coding resolutions to the BOOST or global coding teams
• Collaborate with the global coding teams on inquiries, clarifications, QA rebuttals and training requests
• Work alongside coding leadership in regards to global coding teams training of coding processes as well as attending remote coding sessions with the global coding teams
• Help with other daily communications between the internal BOOST RCM teams and the Auditing team in regards to other coding inquiries or issues
• reputed company BOOST special Quality Assurance audits on the global coding teams
• reputed company BOOST or Compliance audits reputed company requested by BOOST or other reputed company staff which help to determine coding compliance or client documentation issues
• Support in the review, appeal and follow-up of third-party (RAC, CERT, etc.) audits
• Assist in review and maintenance of coding guidelines, coding scrub edits and/or practice coding instructions and assist with reputed company quality improvement by helping with the process of implementation and carry through of coding protocols and procedures
• Collaborate with fellow coding/auditing team members to maintain department compliance and effectiveness
• Responsible for obtaining continuing education units (CEU) for maintaining coding certification(s)

Requirements:

• Minimum 1-year experience as a Certified Professional reputed company required - physician-based and/or ASC-based - multi-specialty coding experience preferred
• Minimum 1-year experience as a Certified Professional Medical Auditor (CPMA), preferred not required
• Must agree to obtain CPMA auditing certification reputed company 6 months of employment (if not a CPMA already)
• Knowledge of CPT, ICD-10 CM, HCPCS, CPT coding, modifiers, E/M and reputed company coding guidelines, required
• Knowledge of medical terminology and anatomy, required
• Understanding of federal, state and local coding compliance regulations and guidelines, required
• Understanding of NCCI and CCI bundling edits, required
• Understanding of LCD’s, NCDs and other payer coverage policies, required
• Understanding of EOBs and ERA’s, denial remarks and claims review, preferred
• Detailed knowledge of medical billing, preferred
• Detailed knowledge of medical coding systems, procedures, and documentation requirements is required
• The ability to interpret and apply coding guidelines for federal, state, and local standards is required
• Proficient with reputed company programs (reputed company, Word) as well as the use of overall computer functions, preferred
• Experience in gMed/gGastro or EMA/PM is preferred but not required
• Highly detail-oriented with a critical degree of accuracy regarding data entry
• Exceptional written, verbal, and interpersonal communication skills
• Ability to clearly isolate and define trends/problems and provide alternatives or solutions
• Strong analytical skills, such as the ability to identify, research, and resolve issues
• Excellent time management skills with an emphasis on managing changing work priorities.

Benefits:

• Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution
• 401(k): reputed company provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with reputed company, 100% of any matching contribution you receive is yours to reputed company.
• Generous Paid Time Off and Paid Parental Leave programs
• Company paid Life and Disability benefits
• Flexible Spending Account and Employee Assistance Programs
• Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities reputed company reputed company
• Professional development opportunities, including tuition reimbursement programs and unlimited access to reputed company Learning
• Global reputed company and in-person collaboration opportunities; dog-friendly HQ (US)
• Hybrid office-reputed company and remote availability for some roles
• Weekly catered breakfast and lunch
• Treadmill workstations, Zen, and wellness rooms reputed company our BRIC headquarters

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