Coding Audit Specialist

Job Summary

A company is looking for a Coding Audit Specialist to review medical records and hospital claims for accuracy and reimbursement.

Key Responsibilities:

• Review medical records and hospital claims to determine if coding changes would affect reimbursement
• Apply insurance contracts to identify underpayments due to billing and coding discrepancies
• Communicate with insurance companies to resolve underpayments and arrange for payment or adjustment processing

Required Qualifications:

• Minimum 2 years of experience in hospital reimbursement or related field
• Basic outpatient and/or inpatient coding skills preferred
• Knowledge of Medicare, Medicaid, and third-party reimbursement guidelines
• Experience with coding systems such as ICD-10, DRG, CPT, PCS, and/or HCPCS
• Proficiency in MS Office Suite, particularly Excel