Medical Coding Auditor

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CenterWell Senior Primary Care

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

Healthcare Insurance

CenterWell Senior Primary Care is a healthcare provider focused on delivering personalized primary care to senior citizens. The company emphasizes a comprehensive and holistic approach to healthcare, addressing the physical, social, and emotional needs of older adults. As part of its service offerings, CenterWell includes home health services and pharmacy support to complement its senior primary care. The organization is committed to offering stability, inclusive benefits, and career growth opportunities for its employees while maintaining a culture of mutual respect and mindfulness. CenterWell is a brand under the larger healthcare entity, Humana.

📋 Description

• The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. • The Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. • Verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions. • Confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines. • Use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines. • Prepare written summaries of audit findings. • Present verbal audit feedback and provide education upon completion of the medical record audit. • Respond to or clarify internal requests for information. • Support and participate in process and quality improvement projects. • Partner with business associates from other departments to understand their needs and concerns, and help develop system solutions.

🎯 Requirements

• This position requires both a CPMA AND CRC and it also requires at least ONE of the certifications from AAPC or AHIMA • 2 or more years of outpatient coding experience (Preferably in a risk adjustment setting) • Knowledge of several reimbursement methodologies, including risk adjustment and fee for service • Proficient in all Microsoft Office applications, including Word and Excel • Public speaking / group presentation skills • Ability to travel locally and overnight within Conviva and CenterWell markets per business need

🏖️ Benefits

• medical, dental and vision benefits • 401(k) retirement savings plan • time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave) • short-term and long-term disability • life insurance