Clinical Auditor with Coding Certification

Job Summary

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

Key Responsibilities

• Conducts audits of outpatient and specialty claims, utilizing medical chart coding principles
• Effectively uses audit tools and maintains productivity and quality standards
• Identifies 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, RHIT) required and maintained
• 5 to 7 years of experience in clinical medical record coding or auditing
• Broad knowledge of medical claims billing/payment systems and coding terminology
• Expert knowledge of coding guidelines, including DRG, ICD-10, CPT, and HCPCS codes