Healthcare Compliance Auditor – Healthcare Transaction & Strategy

Remote Full-time
Job Description: • Plan and perform medical record audits to determine coding accuracy and compliant claims submission • Develop coding and documentation audit methodology using knowledge of key risk areas in coding and documentation compliance • Perform coding and documentation audits, reviewing medical records and charges to ensure compliance with CPT-4/HCPCS and ICD-10-CM coding guidelines and standards • Conduct analysis of audit findings to identify trends/problems in coding and documentation and effectively communicates the audit findings and recommended areas for improvement • Serve as a subject matter expert on interpretation and application of coding and documentation guidelines • Generate client deliverables and make valuable contributions to expert reports • Manage client relationships and communicate results and work product as appropriate Requirements: • An undergraduate degree (e.g., BS, BA) • Active coding certification from either AAPC or AHIMA is required • Preference will be given to candidates that are certified in medical auditing • 2+ years of work experience with a focus on healthcare provider billing and coding • 5-7 years of experience is required for the Managing Consultant level position • Comprehensive knowledge of Medicare rules, regulations, and guidelines as they apply to coverage, coding, and provider documentation • Advanced knowledge of CPT-4, HCPCS, and ICD-10-CM coding systems • Required skills include: demonstrated ability to interpret national coding and documentation guidelines and translate them into effective auditing practices and tools Benefits: • Health insurance • 401(k) matching • Flexible work hours • Paid time off • Remote work options
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