Clinical Auditor Coding Certification

Job Summary

A company is looking for an Auditor Clinical Validation OPSP Coding.

Key Responsibilities

• Conducts audits on outpatient and specialty claims using medical chart coding principles
• Utilizes advanced audit tools to ensure accurate claim entry and maintain productivity standards
• Identifies potential new claim types and recommends process improvements based on extensive healthcare auditing experience

Required Qualifications

• Associate or bachelor's degree in Health Information Management (RHIA or RHIT) or equivalent work 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
• Knowledge of HIPAA Privacy and Security Rules and CMS security requirements
• Expert coding knowledge in DRG, ICD-10, CPT, and HCPCS codes