You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is looking for a Coding Auditor to join their team. The primary responsibilities include developing expertise in CPT, HCPCS, and ICD-10 coding guidelines, efficiently performing policy updates or audits on medical records or claims, and drafting written communications to providers.
Key Responsibilities
- Develop and maintain expertise on CPT, HCPCS, and ICD-10 Coding guidelines and billing requirements.
- Perform thorough and complex policy updates or audits on medical records or claims.
- Document findings clearly for both clinical and non-clinical audiences.
- Create reports and reference guides for team communication and efficiency.
- Assist in drafting provider communication about audit findings.
- Participate in educational calls with providers.
- Train new team members.
- Develop and document team efficiency and effectiveness processes.
- Ensure compliance with all applicable laws and regulations.
- Other duties as assigned.
Qualifications - 1+ years of coding or auditing experience across multiple specialties.
- Certified Professional Coder (CPC) designation or similar certification.
- Bachelor's degree or 4+ years of work experience.
- Experience in health insurance claims processing, billing, reimbursement, or provider contracting.
- Certified Professional Medical Auditor and payment integrity audit experience preferred.
- Experience translating technical jargon for non-technical users.
- Knowledge of HIPAA, data privacy, and data security processes preferred.
- Experience with health insurance regulators preferred.
Benefits - Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
- Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
- 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
- Short Term Disability Insurance.
- Term Life Insurance Plan.
* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview: With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
* As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients