Demo

Medical Coding Auditor - Outpatient

TEKsystems
TEKsystems Salary
Jacksonville, FL Full Time
POSTED ON 2/19/2025
AVAILABLE BEFORE 5/15/2025

Job Description

Job Description

Description

The Medical Coding Auditor - Outpatient is responsible for ensuring the accuracy, integrity, and compliance of medical coding practices within the organization. This role involves auditing medical records, coding data, and billing information to verify adherence to coding guidelines and regulations. The Medical Coding Auditor plays a crucial role in minimizing coding errors, preventing fraudulent activities, and ensuring that the organization meets all applicable standards and requirements. Key Responsibilities to include :

  • 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. Conduct workshops and seminars as needed.
  • Report Generation : Prepare detailed audit reports that highlight findings, trends, and areas for improvement. Present reports to management and relevant stakeholders.
  • 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.

Skills

CPC, EPIC, Auditing, Outpatient, Facility, Same Day surgery, Wound care, Ancillary, CCS, Medical, Hospital, Healthcare, Audit, Medical coding

Top Skills Details

CPC,EPIC,Auditing,Outpatient,Facility,Same Day surgery,Wound care,Ancillary,CCS

Additional Skills & Qualifications

Required and Preferred Qualifications :

  • 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. Other Medical Coding certifications may also qualify.
  • At least three (3) years of direct experience in coding / auditing applicable services, and medical chart review for all provider / claim types in an Outpatient Facility setting .
  • 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. Knowledge, Skills and Abilities Needed :
  • 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.
  • Experience Level

    Intermediate Level

    Pay and Benefits

    The pay range for this position is $38.00 - $40.00 / hr.

    Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following :

  • Medical, dental & vision
  • Critical Illness, Accident, and Hospital
  • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
  • Life Insurance (Voluntary Life & AD&D for the employee and dependents)
  • Short and long-term disability
  • Health Spending Account (HSA)
  • Transportation benefits
  • Employee Assistance Program
  • Time Off / Leave (PTO, Vacation or Sick Leave)
  • Workplace Type

    This is a fully remote position.

    Application Deadline

    This position is anticipated to close on Feb 28, 2025.

    About TEKsystems :

    We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

    The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

    Salary : $38 - $40

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