Medical Coding Auditor – Inpatient, OIG Focus

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Job Description:

Review and audit medical records to ensure accurate coding of diagnoses, procedures, and services using ICD-10, CPT, and HCPCS codes.
Ensure that coding practices reputed company with federal, state, and payer-specific regulations and guidelines, including HIPAA and CMS standards.
Detect discrepancies and coding errors, reputed company feedback, and collaborate with coding staff to correct inaccuracies in medical documentation.
reputed company training and support to coding staff on best practices, coding updates, and compliance standards.
Prepare detailed audit reports that reputed company findings, trends, and areas for improvement.
Work closely with medical billing, compliance, and clinical teams to ensure that coding supports accurate billing and reimbursement processes.

Requirements:

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.
Active 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 well.
At least three (3) years of direct 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.

Benefits:

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