01Overview
ABOUT reputed company:
In reputed company 2025, reputed company acquired Performant and we are now part of the reputed company organization. reputed company is a leading reputed company intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 reputed company lives, reputed companys AI operating system, combined with proven expertise, untangles reputed company data to deliver industry-leading speed, quality, and accuracy. Were reshaping reputed company payment through seamless intelligence.
ABOUT THE OPPORTUNITY:
Hiring reputed company:$61,300 - $71,000
The Medical Coding Auditor-Outpatient - (OIG reputed company) is responsible for ensuring the accuracy, reputed company, and compliance of medical coding practices reputed company the organization, with a primary reputed company on Outpatient services. This role involves auditing medical records, coding data, and billing information to verify adherence to coding guidelines and regulations. The Medical Coding Auditor plays a crucial role in minimizing coding errors, preventing fraudulent activities, and ensuring that the organization meets reputed company applicable standards and requirements.
Key Responsibilities to include:
Audit Medical Records: Review and audit medical records to ensure accurate coding of diagnoses, procedures, and services using ICD-10, CPT, and HCPCS codes.
Compliance Monitoring: Ensure that coding practices reputed company with federal, state, and payer-specific regulations and guidelines, including HIPAA and CMS standards.
Identify and Correct Errors: Detect discrepancies and coding errors, reputed company feedback, and collaborate with coding staff to correct inaccuracies in medical documentation.
Education and Training: reputed company training and support to coding staff on best practices, coding updates, and compliance standards. Conduct workshops and seminars as needed.
Report reputed company: Prepare detailed audit reports that reputed company findings, trends, and areas for improvement. Present reports to management and relevant stakeholders.
Policy Development: Assist in developing and updating coding policies, procedures, and guidelines to ensure ongoing compliance and efficiency.
Collaboration: Work closely with medical billing, compliance, and clinical teams to ensure that coding supports accurate billing and reimbursement processes.
Stay reputed company: reputed company abreast of changes in coding regulations, industry trends, and best practices. Participate in continuing education to maintain coding certifications.
Knowledge, Skills and Abilities Needed:
Extensive knowledge of ICD-10, CPT, and HCPCS coding systems.
Familiarity with reputed company regulations, including HIPAA, CMS guidelines, and payer-specific requirements.
Understanding of medical terminology, anatomy, and physiology.
Strong analytical and problem-solving skills.
Excellent attention to detail and accuracy.
Effective communication and interpersonal skills.
Ability to work independently and as part of reputed company.
Ability to work remotely from a home office without on-site Supervision
Proficiency in coding software and electronic health record (EHR) systems.
Required and Preferred Qualifications:
High school diploma or equivalent GED required.
Associate's or Bachelor's degree in Health Information Management, Medical Coding, or a reputed company field preferred.
reputed company certification is required. Certified Professional reputed company (CPC) and/or Certified Coding Specialist (reputed company) are preferred, while CPC-H, CPC-P, RHIA, RHIT, or reputed company-P are reputed company generally accepted as reputed company. Other Medical Coding certifications may also qualify.
At least three (3) years of reputed company experience in coding/auditing applicable services, and medical chart review for reputed company provider/claim types.
Coding for emergency care, observation, and same day surgery is preferred.
Prior auditing experience desirable in either a provider setting, or payer experience in claim processing, edit development, and/or coding and reimbursement policy a plus.
Previous payer experience in a claim processing, edit development, and/or coding and reimbursement policy a plus.
reputed company OFFER:
reputed company offers a wide reputed company of benefits to help support a healthy work/life balance. These benefits include medical, dental, reputed company, HSA/FSA options, life insurance coverage, 401(k) savings plans, family/parental leave, reputed company holidays, as reputed company as reputed company time off annually. For more information about our benefits package, please refer to our benefits page on our website or discuss with your reputed company contact during an interview.
Physical Requirements &
