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Coding Compliance Auditor

fresno, ca • Posted 4 days ago
Onsite Full Time General

Coding Compliance AuditorThe Coding Compliance Auditor is a member of the Compliance Office and contributes to the Community Health System's mission to better the lives of all those we serve. As a Coding Compliance Auditor, you will be responsible for conducting coding and documentation audits to ensure accurate code assignment, appropriate billing, integrity of the medical record, and compliance with federal and state healthcare program requirements.The role requires a highly confident coder who can audit both facility coding and professional fees for partners, as well as audit other coders and physicians.EducationAssociate's Degree in Business, Information Systems, Nursing, Health Care, or a related field requiredBachelor's Degree in Business, Information Systems, Nursing, Health Care, or a related field preferredExperienceExperience performing medical record and billing audits/reviews, including clinical documentation, medical terminology, codes (CPT, HCPCS, ICD-10-CM, and revenue), and reviews for charge and reimbursement accuracy requiredKnowledge of federal, state, and private payer guidelines requiredOne of the following is required:5 years of healthcare coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCS, if qualifying with an Associate's Degree3 years of healthcare coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCS, if qualifying with a Bachelor's DegreeEpic experience preferredExperience with 3M or Optum is preferredExperience completing a formal validation report after completing audits preferred.Licenses and Certifications:One of the following is required: CCS - Certified Coding SpecialistCCS-P - Certified Coding Specialist- Physician-basedCMAS - Certified Medical Audit SpecialistCPMA - Certified Professional Medical AuditorCPC - Certified Professional CoderAdditional certifications preferred: RHIA - Registered Health Information AdministratorRHIT - Registered Health Information TechnicianTwo or more certifications preferredDisclaimers• Pay ranges listed are an estimate and subject to change. • If any bonuses are noted, they are only applicable to external hires meeting criteria.

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