Outpatient Coding Auditor
New
E
EnsembleMedical coding
Source API remote eligibility restrictions: United StatesFull-TimeMiddle
SalaryThis position will pay between $57,400 to $99,000 based on experience
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Job Details
- Experience
- 3+ years of outpatient facility coding experience; 3+ years of auditing experience
- Required Skills
- Microsoft Excel
Requirements
- Have at least 3 years of outpatient facility coding experience.
- Have at least 3 years of auditing experience.
- Hold a high school diploma or GED.
- Maintain at least one of these certifications: CPC, CCS, RHIA, or RHIT; CCS is preferred.
- Have advanced knowledge of medical coding and billing systems, documentation, and regulatory requirements.
- Know legal, regulatory, and policy compliance issues related to medical coding, billing procedures, and documentation.
- Be competent with Microsoft Office applications, including Word, Excel, and PowerPoint.
- Be able to communicate medical information clearly to professional practitioners and/or the general public.
- Be able to provide guidance and training to professional and technical staff in the area of expertise.
- Be willing and able to travel to and work onsite at client, temporary, or corporate locations as business needs require.
Responsibilities
- Audit outpatient work types for accurate diagnoses, CPT and HCPCS coding, CCI edits, and modifier assignment.
- Assess coding against clinical documentation, coding and CDI guidelines, and applicable regulatory standards.
- Document root-cause issues using spreadsheets, account examples, and claim examples.
- Research governmental, payer-specific, hospital-specific, regulatory, and literature requirements.
- Recommend actions to clients based on coding and billing requirements.
- Assist with executive summary reports and client coding education and training materials.
- Attend coding conferences, workshops, and in-house sessions to stay current on coding and regulatory changes.
- Meet established productivity standards and coding certification requirements.
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