Medical Coding Auditor, Outpatient

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September 4

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BASF

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Chemicals • Agriculture • Healthcare

BASF is a global chemical company that operates across multiple sectors, providing a wide range of products and solutions. The company is focused on innovation and sustainability, serving industries such as agriculture, automotive, construction, electronics, energy, and healthcare. With a commitment to research and development, BASF aims to create chemicals that enhance the quality of life and support sustainable practices worldwide.

10,000+ employees

Founded 1865

🌾 Agriculture

📋 Description

• The Medical Coding Auditor-Outpatient is responsible for ensuring the accuracy, integrity, and compliance of medical coding practices within the organization, with a primary focus on Outpatient services. • 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 comply with federal, state, and payer-specific regulations and guidelines, including HIPAA and CMS standards. • Identify and Correct Errors: Detect discrepancies and coding errors, provide feedback, and collaborate with coding staff to correct inaccuracies in medical documentation. • Education and Training: Provide training and support to coding staff on best practices, coding updates, and compliance standards. • Report Generation: Prepare detailed audit reports that highlight findings, trends, and areas for improvement. • 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 Current: Keep abreast of changes in coding regulations, industry trends, and best practices. Participate in continuing education to maintain coding certifications.

🎯 Requirements

• Extensive knowledge of ICD-10, CPT, and HCPCS coding systems. • Familiarity with healthcare 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 a team. • Ability to work remotely from a home office without on-site Supervision • Proficiency in coding software and electronic health record (EHR) systems. • High school diploma or equivalent GED required. • Associate's or Bachelor's degree in Health Information Management, Medical Coding, or a related field preferred. • Active certification is required. Certified Professional Coder (CPC) and/or Certified Coding Specialist (CCS) are preferred, while CPC-H, CPC-P, RHIA, RHIT, or CCS-P are all generally accepted as well. • At least three (3) years of direct experience in coding/auditing applicable services, and medical chart review for all 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

• Performant offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, as well as sick time and vacation time off annually.