Coding Auditor

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔎 Auditor

🚫👨‍🎓 No degree required

👻 Ghost score 15%

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Prisma Health Urgent Care

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

👥 B2C

🧘 Wellness

Healthcare • B2C • Wellness

Prisma Health Urgent Care is a network of modern urgent care clinics operated by Prisma Health serving the Upstate and Midlands of South Carolina, offering walk-in and booked appointments as well as virtual visits. The centers provide immediate, non-emergency medical services such as urgent care treatment, COVID-19 testing, seasonal allergy care, sports physicals, occupational health services, and on-site diagnostics, staffed by board-certified clinicians and open seven days a week.

📋 Description

• Perform coding audits of provider documentation and assigned CPT and ICD-10 codes • Evaluate whether clinical documentation supports diagnoses and procedures billed • Identify coding errors, documentation deficiencies, charge-capture issues, and improvement opportunities • Review coding deliverables from professional coders, physicians, and other healthcare professionals • Provide constructive, educational feedback to providers and coders • Deliver education on coding requirements, documentation standards, and regulatory updates • Stay current on CMS, state, and payer coding regulations and requirements • Collaborate with the Coding Supervisor and Regional Medical Directors to improve documentation and coding accuracy • Perform charge entry and Charge Review activities as needed • Identify recurring coding trends such as undercoding and recommend corrective actions • Support error correction and process improvement initiatives • Meet established daily production and quality standards

🎯 Requirements

• Active CPC or CCS coding certification through AAPC or AHIMA • Relevant professional coding and/or coding auditing experience • 2+ years of medical billing experience • Urgent Care or Occupational Health billing experience • Experience working with insurance payers, A/R, revenue cycle processes, and denied claims • Experience with billing software and electronic medical records • High school diploma or equivalent • Strong understanding of medical coding and documentation requirements • Excellent critical-thinking and analytical skills • Ability to distinguish between a coding error and a documentation deficiency • Strong attention to detail and commitment to accuracy • Ability to communicate audit findings clearly and constructively • Ability to provide corrective feedback and educate providers and coders • Strong organizational skills and ability to manage a high-volume workload • Ability to identify coding trends and develop practical solutions • Ability to stay current with coding changes and regulatory requirements • Positive, collaborative attitude and ability to work effectively in a fast-paced environment

🏖️ Benefits

• Full-time remote work arrangement • Meaningful work improving the patient experience • Supportive, growing organization • Opportunities to educate providers and coders and contribute to professional improvement • Collaborative partnership with leadership and medical directors