Medical Coding Auditor

Job Description

Job Description

Job Summary

We are seeking a detail-oriented and motivated Auditor to join our dynamic team. In this vital role, you will be responsible for reviewing and analyzing medical records, billing practices, and coding accuracy to ensure compliance with industry standards and regulations. Your expertise will help maintain the integrity of healthcare data, improve billing processes, and support the overall quality of healthcare services. This position offers an exciting opportunity to contribute to the efficiency and accuracy of medical documentation and reimbursement processes while working in a collaborative and fast-paced environment.

Duties :

Conduct thorough audits of medical records to verify completeness, accuracy, and compliance with established guidelines.

Review coding practices including DRG (Diagnosis-Related Group), CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding to ensure proper classification of diagnoses and procedures.

Analyze medical billing submissions for correctness and adherence to payer requirements.

Identify discrepancies or errors in medical documentation, coding, or billing, and communicate findings clearly to relevant departments for correction.

Collaborate with healthcare providers, billing specialists, and management to implement process improvements based on audit findings.

Maintain detailed records of audit activities, findings, and corrective actions taken.

Stay current with industry standards, regulatory changes, and updates related to medical coding systems and billing practices.

Assist in training staff on proper documentation and coding procedures to reduce errors and enhance compliance.

Utilize Electronic Medical Record (EMR) systems and Electronic Health Record (EHR) systems efficiently for data review and documentation audits.

Ensure all medical records are properly organized, secured, and accessible for review purposes.

Requirements

Skills :

Strong knowledge of medical terminology, anatomy, and physiology is essential for accurate record review.

Proficiency in medical coding systems including DRG, CPT coding, ICD-9, ICD-10, and ICD coding standards.

Experience with medical billing processes and medical collection procedures.

Familiarity with EMR systems and EHR systems used in healthcare settings.

Excellent analytical skills with keen attention to detail for identifying discrepancies or errors in complex data sets.

Ability to interpret healthcare regulations and compliance standards effectively.

Strong communication skills for documenting findings clearly and collaborating across teams.

Prior experience in medical office environments or healthcare administration is preferred. Join us as an Auditor to ensure the highest standards of accuracy in healthcare documentation while supporting the integrity of our organization’s financial health. Your expertise will directly impact patient care quality by promoting precise record keeping and compliance!