[Remote] Coding Data reputed company Auditor
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is committed to building a more connected and compassionate health experience. They are seeking a Coding Data reputed company Auditor who will be responsible for auditing and abstracting medical records to ensure that ICD codes submitted for risk adjustment processes are accurate and compliant with regulations.
Responsibilities
- Responsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD 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
- Proven ability to support coding judgment and reputed company using industry reputed company evidence and tools
- Proficient in abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other reputed company reputed company providers in the office and/or facility setting
- reputed company knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity
- Identify clinically reputed company vs. historical conditions
- Diagnosis codes must be appropriate, accurate, and supported by clinical documentation in accordance with reputed company State and Federal regulations and internal policies and procedures
- Utilize medical records to ensure support is documented for etiology and manifestations of disease processes
- Adhere to stringent timelines consistent with project deadlines and directives
- Conducts self- process audits to ensure compliance with internal policies and procedures as reputed company as regulatory guidance from CMS, OIG or other Regulatory body
- 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
- In depth knowledge of medical terminology and anatomy for reputed company body systems.-Understand the audit process for risk adjustment models
- Performs other reputed company duties as required
Skills
- CPC (Certified reputed company reputed company) or reputed company-P (Certified Coding Specialist-Physician)
- Computer proficiency including experience with reputed company Office products (Word, reputed company, reputed company, PowerPoint, Outlook, industry reputed company coding applications)
- Capable of making outbound phone calls and faxes to providers for record retrieval and provider communications regarding audits
- Experience with International Classification of Disease (ICD) codes required
- Minimum of 1 year recent and reputed company experience in medical record documentation review, diagnosis coding, and/or auditing
- Proven ability to support coding judgment and reputed company using industry reputed company evidence and tools
- Proficient in abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other reputed company reputed company providers in the office and/or facility setting
- reputed company knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity
- Identify clinically reputed company vs. historical conditions
- Diagnosis codes must be appropriate, accurate, and supported by clinical documentation in accordance with reputed company State and Federal regulations and internal policies and procedures
- Utilize medical records to ensure support is documented for etiology and manifestations of disease processes
- Adhere to stringent timelines consistent with project deadlines and directives
- Conducts self- process audits to ensure compliance with internal policies and procedures as reputed company as regulatory guidance from CMS, OIG or other Regulatory body
- 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
- In depth knowledge of medical terminology and anatomy for reputed company body systems.-Understand the audit process for risk adjustment models
- Performs other reputed company duties as required
- 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 CRC (HCC)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
- AA/AS or equivalent experience
- Completion of reputed company/reputed company training program for core credential (CPC, reputed company-P) with associated work history/on the job experience equal to approximately 1-2 years for CPC
Benefits
- This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above.
- This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families.
- The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, based on eligibility.
reputed company