Certified Professional Medical Coding Auditor

Job not on LinkedIn

🔥 18 hours ago

🇺🇸 United States – Remote

💵 $75k - $95k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Tegria

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2020

💼 Consulting

🏥 Healthcare

⚕️ Healthcare Insurance

Consulting • Healthcare • Healthcare Insurance

Tegria is a global healthcare consulting and services company that partners with provider and payer organizations to advance care, improve performance, and tackle the biggest challenges in healthcare. They offer a range of services including patient access optimization, data analytics, cloud solutions, and revenue cycle transformation to create value and enhance healthcare delivery. Tegria focuses on streamlining operations, fostering innovation, and leveraging technology to maximize performance and improve patient experiences.

📋 Description

• Evaluate the accuracy, consistency, and quality of coded medical records completed by internal and external coding staff • Conduct routine monthly, retrospective, concurrent, and targeted coding audits • Audit ICD-10-CM, CPT, HCPCS Level II, ICD-10-PCS, and modifier codes • Evaluate coding accuracy, completeness, consistency, and compliance with guidelines and organizational standards • Validate code assignment and sequencing based on provider documentation • Resolve routine coding questions and escalate complex or ambiguous issues • Identify coding errors, trends, compliance concerns, revenue concerns, and process-improvement opportunities • Monitor coding quality metrics and assist with scorecard development and reporting • Provide timely, constructive, individualized feedback to coders • Identify educational and developmental needs and contribute to coding education sessions • Create tip sheets, coding guidance documents, case studies, and training materials • Assist with onboarding and mentoring newly hired coders • Support corrective action plans and individualized education plans • Serve as a coding resource and assist with complex coding questions • Monitor regulatory and coding guideline changes and communicate their impact • Assist with internal and external coding quality reviews • Analyze audit data and prepare reports with findings and supporting documentation • Track coder performance improvement and measure educational effectiveness • Recommend workflow improvements and process standardization • Partner with the Coding Manager and Coding Leads on audit, education, and coder development efforts • Contribute to coding policy and procedure development • Leverage approved AI tools to improve productivity, accuracy, and decision-making • Perform other generally related duties as assigned

🎯 Requirements

• High school diploma or equivalent required • Associates or Bachelor's degree in Health Information Management or related healthcare field preferred • Current Certified Professional Medical Auditor (CPMA) certification • One of the following AAPC or AHIMA certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Outpatient Coder (COC), RHIT, or RHIA • Minimum 3 years of medical coding experience in professional and/or facility coding • Minimum 1 year of coding quality review, auditing, or coding education experience • Ability to work with general direction and exercise sound judgment on coding issues • Strong working knowledge of ICD-10-CM, CPT, HCPCS Level II, ICD-10-PCS, and official coding guidelines • Solid understanding of coding quality methodologies and audit principles • W2 project-based consultants must provide a computing device adhering to industry standards and security best practices • Productivity, responsiveness, and reliability in a remote working environment • Ability to exercise sound, independent judgment on ambiguous or complex coding issues • Objectivity and consistency in evaluating others' work • Clear and constructive communication • Ability to stay current and adaptable as coding guidelines and regulations evolve • Strong attention to detail and trend-level thinking • Ability to manage competing priorities and deadlines • Patience and constructive mindset when coaching and developing others • Ownership and follow-through

🏖️ Benefits

• Multiple health and dental plans with nationally recognized networks • Vision benefits • Total wellness program • Employee assistance program for employee and family • Retirement savings plans • Company-paid disability and life insurance • Pre-tax savings opportunities (HSA and/or FSA) • Professional development offerings • Remote work opportunities • Generous paid-time-off program • Flexible schedule accommodations