Hcfraudshield
Chesterfield, MO
Coding Auditor
Department: SIU
Employment Type: Full Time
Location: Headquarters
Description
The Coding Auditor is a professional auditing role designed for a certified professional coder. Under direct supervision of Healthcare Fraud Shield SIU management, this position executes routine coding reviews to ensure health records align accurately with billed ICD-10-CM, CPT, HCPCS, Revenue codes. The ideal candidate has a strong foundation in primary medical coding and a keen eye for detail, eager to learn complex audit frameworks, regulatory policies, and documentation validation.
Key Responsibilities
Compare the procedures and codes billed on a claim to a medical record.
Compare information submitted on the claims in order to determine amount and nature of billable services as needed.
Determines appropriateness of billing and reimbursement as needed.
Documents findings for each claim line in a spreadsheet as needed.
Summarize findings in a written report as needed....