Salary:
Medical Coding Auditor
Position Overview
The Medical Coding Auditor performs detailed audits of both outpatient and inpatient medical records to ensure coding accuracy, compliance, and consistency with regulatory and payer standards. This role identifies errors, provides corrective feedback, and supports quality assurance and revenue integrity.
Key Responsibilities
- Conduct audits of outpatient and inpatient medical records for coding accuracy, completeness, and compliance.
- Review cases against ICD-10-CM, CPT, and HCPCS coding standards, including DRG assignments for inpatients.
- Identify coding discrepancies, documentation deficiencies, and compliance issues.
- Provide detailed audit reports and actionable recommendations.
- Collaborate with coders and providers to improve coding accuracy and documentation practices.
- Track audit findings and maintain records for management and regulatory review.
- Support compliance initiatives and ensure adherence to HIPAA and other regulatory requirements.
- Participate in training programs to enhance coding quality across the team.
Qualifications and Experience
- Minimum of 35 years of experience in medical coding and auditing.
- In-depth knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
- Experience auditing both outpatient and inpatient coding environments.
- Strong understanding of healthcare compliance, revenue cycle processes, and payer regulations.
- Experience providing feedback and training on coding accuracy.
Required Skills
- Exceptional attention to detail and analytical ability.
- Strong communication skills for collaborative education and corrective guidance.
- Ability to identify trends and implement corrective actions.
- Proficiency in audit tracking, reporting tools, and EHR/medical billing systems.
Certifications
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Coding Auditor (CCA) preferred.
- Continuing education to maintain certification.
Clearance Requirement
- Must be able to obtain and maintain any required background checks or access authorizations if applicable.
Salary Range