Job Description:
• Plan and perform medical record audits to determine coding accuracy and compliant claims submission
• Develop coding and documentation audit methodology using knowledge of key risk areas in coding and documentation compliance
• Perform coding and documentation audits, reviewing medical records and charges to ensure compliance with CPT-4/HCPCS and ICD-10-CM coding guidelines and standards
• Conduct analysis of audit findings to identify trends/problems in coding and documentation and effectively communicates the audit findings and recommended areas for improvement
• Serve as a subject matter expert on interpretation and application of coding and documentation guidelines
• Generate client deliverables and make valuable contributions to expert reports
• Manage client relationships and communicate results and work product as appropriate
Requirements:
• An undergraduate degree (e.g., BS, BA)
• Active coding certification from either AAPC or AHIMA is required
• Preference will be given to candidates that are certified in medical auditing
• 2+ years of work experience with a focus on healthcare provider billing and coding
• 5-7 years of experience is required for the Managing Consultant level position
• Comprehensive knowledge of Medicare rules, regulations, and guidelines as they apply to coverage, coding, and provider documentation
• Advanced knowledge of CPT-4, HCPCS, and ICD-10-CM coding systems
• Required skills include: demonstrated ability to interpret national coding and documentation guidelines and translate them into effective auditing practices and tools
Benefits:
• Health insurance
• 401(k) matching
• Flexible work hours
• Paid time off
• Remote work options