Medical Auditor

Job not on LinkedIn

🕒 Yesterday

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

⏰ Full Time

🟢 Junior

🔎 Auditor

👻 Ghost score 10%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

ExactCare

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2009

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

💰 Private Equity Round on 2016-03

Healthcare • Healthcare Insurance • Pharmaceuticals

ExactCare is a leading pharmacy care management provider that specializes in medication management for individuals with complex, chronic medical needs. With operations in all 50 states and Washington, D. C. , ExactCare supports more than 100,000 people nationwide, helping them manage their medications in assisted living, long-term care facilities, and at home. Partnering with healthcare organizations, ExactCare aims to improve clinical outcomes by ensuring better medication adherence, reducing readmissions, and lowering overall healthcare costs.

📋 Description

• Perform clinical validation audits and interpret medical documentation to ensure accurate capture of patient conditions in compliance with coding guidelines • Conduct prospective, retrospective, and RADV audits as requested by clients • Apply coding principles during medical audit activities and provide education as needed • Compile detailed findings and prepare client reports after medical record audits • Review audit results with clients monthly or as needed • Provide feedback and process improvement recommendations to the Client Service Liaison • Participate in workgroups, committee meetings, process improvement initiatives, department meetings, client calls, and performance evaluations • Advise the Client Service Liaison of potential trends in inappropriate utilization • Maintain current professional licenses and certifications • Attend training conferences, webinars, workshops, and review industry publications to stay current on ICD-10-CM coding, documentation, laws, and regulations • Adhere to HIPAA requirements • Embody AnewHealth’s core values • Perform other duties as assigned

🎯 Requirements

• Professional Medical Coder Certification: CCS issued by the American Health Information Management Association, CPC, or RHIT with 6 months of ICD-10-CM coding experience • CRC certification preferred • CPMA preferred • Experience in clinical documentation improvement • Experience with Hierarchical Condition Categories (HCC) • Knowledge of or experience with Medicare Advantage plans • Knowledge of or experience in managed health care systems, PACE, or Medicare • Experience with MS Word, Excel, and PowerPoint • Comfortable learning and becoming an expert on new and proprietary software • Must maintain professional license and certifications • Must be able to commute to multiple site locations within assigned territory • May be required to work extended hours • Availability outside normal business hours on an ad-hoc basis • Applicants must be eligible to work in this country

🏖️ Benefits

• Medical, dental, and vision coverage • Flexible spending account • Company-paid life insurance • Short-term disability coverage • Voluntary benefits • 401(k) • Paid Time Off • Paid holidays • Flexible remote work arrangement

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume