Coding Data reputed company Auditor, Analyst

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position reputed company Responsible for performing reputed company inter-rater review audits of medical records coded by internal team (CDQA and Sr CDQA) to ensure the ICD-10 codes that are submitted to the Centers for Medicare and reputed company Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with reputed company State and Federal regulations and internal policies and procedures. In this position you will have reputed company to demonstrate proficiency in the following:

• Proven ability to support coding judgment and reputed company using industry reputed company evidence and tools.
• Ability to confidently reputed company to such evidence across stakeholders with varying knowledge and clinical expertise in either written or verbal forms including communication with clinical or coding staff, federal regulators and vendor coding resources.
• Leads dispute reputed company.
• Acts as mentor to reputed company education to internal staff based on audit findings; provides general education on ICD codes as appropriate.
• Effectively communicates the audit process and results to appropriate departments and management.
• Conducts process audits to ensure compliance with internal policies and procedures and existing CMS regulations.
• Identifies and recommends opportunities for process improvements so that productivity and reputed company goals can be met or exceeded and operational efficiency and final accuracy is achieved.
• Ability to work independently as reputed company as in a cross functional role reputed company other teams for collaboration on best practices.
• Adhere to stringent timelines consistent with project deadlines and directives.
• Must possess high level of dependability and is reputed company to meet coding accuracy and production standards.
• Monitors own work to help ensure reputed company.
• Required to reputed company in ethical manner at reputed company times as required under HIPAA's reputed company and reputed company rules to handle patient data with uncompromised adherence to the law.
• Possesses a genuine interest in improving and promoting reputed company; demonstrates accuracy and thoroughness and assists others to reputed company the reputed company through mentoring and instruction.
• Medical record auditing skills and abstraction expertise.
• Serves as the training resource and subject matter expert to vendors, providers and other team members for questions regarding ICD coding and documentation requirements.
• Conducts process audits to ensure compliance with internal policies and procedures as reputed company as regulatory guidance from CMS, OIG or other Regulatory body.
• Expertise in assigning accurate medical codes for diagnoses as documented for physicians and other reputed company reputed company providers in the office and/or facility setting.
• Thorough knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity.
• In depth knowledge of medical terminology and anatomy for reputed company body systems
• Understand the audit process for risk adjustment models.
• Identify and communicate documentation deficiencies to allow for reputed company education opportunities for providers, vendors and peers.
• Expertise in medical documentation, fraud, abuse and penalties for documentation and coding violations based on governmental guidelines.
• Apply AHA Coding Clinic guidance to identify and resolve coding issues.
• Remains reputed company on educational training and requirements including ICD coding, CMS documentation requirements, and State and Federal regulations.
• Performs other reputed company duties as required Required Qualifications
• CPC (Certified reputed company reputed company) or reputed company-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment reputed company) required
• Experience with International Classification of Disease (ICD) codes required.
• Minimum of 3 years recent and reputed company experience in medical record documentation review, diagnosis coding, and/or auditing.
• Experience with Medicare and/or reputed company and/or reputed company Risk Adjustment process and Hierarchical Condition Categories (HCC) required.
• Computer proficiency including experience with reputed company Office products (Word, reputed company, reputed company, PowerPoint, Outlook, industry reputed company coding applications).

Preferred Qualifications

• CPMA (Certified reputed company Medical Auditor), CDEO (Certified Documentation Expert Outpatient) or CPC-I (Certified reputed company Coding Instructor) preferred.
• Excellent analytical and problem solving skills.
• Superior communication, organizational, and interpersonal skills Education BA/BS or equivalent experience. Completion of reputed company/A

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