Senior Coding Auditor, Itemized Bill Reviewer- Remote

Summary

We are seeking a talented individual for a Senior Coding Auditor, Itemized Bill Reviewer who is responsible for performing itemized bill review, chart review, and coding validation to ensure that billed services were ordered, allowable, and accurately documented in the patient record. The candidate must have an extensive background in inpatient hospital bill auditing, outpatient facility coding with charge master review.

Your role in our mission

• Verify that all lines on an itemized bill accurately reflect the services and procedures performed, are covered benefits, were appropriately ordered, properly documented, and reimbursed in accordance with plan policies and provider contract terms.
• Evaluate documentation to ensure accurate coding, charging, and reimbursement for inpatient hospital and outpatient facility services.
• Utilize proprietary auditing systems with a high level of proficiency to document audit findings and rationale. 
• Consistently achieve productivity and quality performance standards established by management.
• Actively cross-train to perform reviews of multiple claim types to provide a flexible workforce to meet client needs
• Assists management with training new Coding Auditors to include daily monitoring, mentoring, feedback and education.
• Maintains current knowledge of coding guidelines and successfully completes required CEUs to maintain coding certification.
• Responsible for attending training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations

What we're looking for

• One or more active professional credentials through AHIMA or AAPC: CPC, COC, CCS, RHIA, RHIT; required
• 2+ years experience of inpatient hospital bill auditing, outpatient facility coding with charge master review; strongly preferred
• Demonstrated proficiency in medical record auditing and ICD-10 CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodology.
• Strong working knowledge of hospital billing/charging including UB-04’s, itemized bills, revenue codes, CPT/HCPCS codes, ICD10 diagnosis and procedure codes
• Demonstrated proficiency in computer skills and typing, i.e., Microsoft Windows, Outlook, Excel, Word, PowerPoint, Internet browsers and in virtual meeting tools i.e., Microsoft Teams, Zoom, etc.

What you should expect in this role