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Title

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Coding Auditor

Description

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We are looking for a meticulous and detail-oriented Coding Auditor to join our team. In this role, you will be responsible for reviewing and analyzing medical coding and billing processes to ensure compliance with regulatory standards and accuracy in documentation. The ideal candidate will have a strong understanding of medical terminology, coding systems such as ICD-10, CPT, and HCPCS, and a keen eye for identifying discrepancies or errors. As a Coding Auditor, you will play a critical role in maintaining the integrity of our billing practices, minimizing financial risks, and ensuring that our organization adheres to all applicable laws and guidelines. Your expertise will also contribute to the training and development of our coding staff, ensuring continuous improvement in our processes. This position requires excellent analytical skills, a commitment to confidentiality, and the ability to communicate effectively with various stakeholders, including healthcare providers, billing teams, and compliance officers. If you are passionate about accuracy, compliance, and contributing to the financial health of a healthcare organization, we encourage you to apply.

Responsibilities

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  • Review and audit medical coding and billing for accuracy and compliance.
  • Ensure adherence to regulatory standards, including HIPAA and CMS guidelines.
  • Identify and correct coding errors or discrepancies in medical records.
  • Provide feedback and training to coding staff to improve accuracy.
  • Collaborate with healthcare providers to clarify documentation and coding issues.
  • Prepare detailed audit reports and present findings to management.
  • Stay updated on changes in coding standards, regulations, and best practices.
  • Assist in developing and implementing coding policies and procedures.

Requirements

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  • Certification in medical coding (e.g., CPC, CCS, or equivalent).
  • Strong knowledge of ICD-10, CPT, and HCPCS coding systems.
  • Experience in medical coding, auditing, or a related field.
  • Excellent analytical and problem-solving skills.
  • Attention to detail and a high level of accuracy.
  • Strong communication and interpersonal skills.
  • Ability to maintain confidentiality and handle sensitive information.
  • Proficiency in using coding and billing software.

Potential interview questions

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  • Can you describe your experience with medical coding and auditing?
  • How do you stay updated on changes in coding standards and regulations?
  • What steps do you take to ensure accuracy in your audits?
  • Can you provide an example of a time you identified and resolved a coding discrepancy?
  • How do you handle situations where documentation from healthcare providers is unclear?
  • What coding certifications do you hold, and how have they prepared you for this role?
  • How do you approach training and mentoring coding staff?
  • What tools or software are you proficient in for coding and auditing?