The Clinical Coding Auditor performs a variety of duties related to compliance and coding, ensuring the usage of the most accurate codes for reimbursement purposes, statistical analysis outcomes, and financial and strategic planning. The Auditor can demonstrate not only the knowledge of coding principles but also the ability to apply those principles in practice.
Qualifications
MINIMUM REQUIREMENTS:
- High school diploma is required, relevant college education preferred.
- A CPC is necessary upon hire. The CPMA must be obtained within 12 months of hire.
- Minimum of two (2) years auditing experience and a minimum of three (3) years experience in physician billing, preferably in a multi-specialty physician group, required
- In depth knowledge of third party reimbursement policies and procedures and a minimum of five (5) years experience in the healthcare industry required
- Knowledge of classification systems, including CPT, E&M, ICD-10, and HCPCS nomenclature, coding rules and guidelines, coding conventions established by the American Medical Association, the Center for Medicare and Medicaid, and AAPC for assignment of diagnostic and procedural codes required
- Knowledge of data collection methods and statistical reporting, Health Information Management theory, principles, practices, techniques, concepts, and policies required
- Demonstrated high degree of accuracy in auditing and statistical analysis
- Knowledge of legal and regulatory requirements of medical records required
- Knowledge of medical terminology and anatomy required
- Ability to read medical records to find and resolve documentation discrepancies required; familiarity with eClinical Works EMR/Practice management system and/or EPIC preferred
- Competency with computer spreadsheet applications and database software required
- Effective oral and written communication required
EEO Statement It is the policy of Cooley Dickinson Health Care to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Cooley Dickinson Health Care will provide reasonable accommodations for qualified individuals with disabilities.
Cooley Dickinson Health Care embraces diverse skills, perspectives and ideas, and encourages people of color, veterans, people with disabilities, LGBTQ candidates, and people from other underrepresented groups to apply