Certified Coding Auditor

Job Summary

Focused on Coding & Clinical Chart Validation, the full-time Certified Coding Auditor will conduct audits of outpatient and specialty claims, ensuring coding accuracy and compliance with medical necessity and treatment appropriateness.

Key responsibilities

• Audits outpatient and specialty claims using medical chart coding principles and client-specific guidelines
• Utilizes advanced audit tools and maintains productivity and quality standards in auditing processes
• Identifies new claim types and recommends improvements to enhance audit production and client satisfaction

Required qualifications

• Associate or bachelor's degree in Health Information Management (RHIA or RHIT) or equivalent experience
• Coding certification (e.g., CPC, CIC, CCS, CCS-P, RHIA, or RHIT) required and maintained
• 5 to 7 years of experience in clinical medical record coding or auditing, with knowledge of HIPAA and CMS requirements
• Expert knowledge of coding guidelines, including DRG, ICD-10, CPT, and HCPCS codes
• Ability to work independently and collaboratively in a team environment