Highmark Health
Trenton, NJ, USA
Company: Allegheny Health Network Job Description: GENERAL OVERVIEW: Join our dynamic team as a Coding Auditor Instructor, where you will play a critical role in ensuring the accuracy and compliance of coding, billing, and medical documentation. You will conduct comprehensive audits on medical records relating to DRGs, APCs, CPTs, and HCPCS Level II codes. Your expertise will help us optimize reimbursement strategies and improve data quality while adhering to regulatory requirements. ESSENTIAL RESPONSIBILITIES: Lead audits and assess the documentation, coding, and billing practices across various AHN entities. Develop and implement training programs tailored to address deficiencies discovered during audits, ensuring compliance with regulatory standards. Work closely with management on external audit findings and participate in strategic discussions to resolve issues. (20%) Create detailed audit reports to highlight coding, documentation, and financial...