CPC Certified Coding Auditor

Job Summary

A company is looking for a Coding Auditor to conduct claims payment quality reviews and clinical coding compliance audits.

Key Responsibilities

• Communicating audit results and recommending corrective actions
• Reviewing claims materials and assessing the accuracy of submitted claims
• Planning investigations for claims, identifying potential fraud, and documenting audit results

Required Qualifications

• Bachelor's degree or equivalent work experience required
• Minimum of 2 years of professional coding and auditing experience
• Current AHIMA or AAPC coding certification required, or ability to obtain certification within one year
• Experience with provider reimbursement methodologies and applicable billing requirements
• Proficiency in Microsoft Office applications