Coding Auditor

Healthcare Fraud Shield · Удалённо · United States

# Coding Auditor **Healthcare Fraud Shield** · United States · `Remote` · `Full Time` 💼 **Уровень роли:** `Mid-level` 🕒 **Статус:** *Опубликовано: сегодня* · *Источник: Himalayas (JSON API)* --- ### Top Skills & Match 🎯 **Ключевой стек роли:** `[Coding-Auditor]` `[Medical-Coder]` `[Healthcare-Auditor]` `[Medical-Billing-Auditor]` `[Compliance-Auditor]` `[Coding-Auditing]` `[Coding-Compliance-Auditor]` `[Coding-Quality-Auditor]` `[Coding-Audit]` `[Coding-Quality-Auditing]` `[Medical-Coding-Auditor]` `[Healthcare-Coding-Auditor]` `[Clinical-Coding-Auditor]` --- ### About the Role 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. - Abstracts CPT, HCPCS, Revenue Codes, DRG codes, and ICD-10 from medical records as needed. - Responsible for maintaining current knowledge of coding guidelines and relevant federal and/or state regulations as needed. - Understands and complies with all company Privacy and Security standards. - Employee may not use or disclose any protected health information, except as otherwise permitted, or required, by law. - On average, there are a minimum of 5-10 claim line reviews per hour. - Other duties as needed. Skills, Knowledge and Expertise - Knowledge of medical terminology. - Knowledge of coding including CPT, HCPCS, Revenue Codes, DRG Codes, and ICD-10. - Knowledge of specialty medical practices. - Must be detail oriented. - Ability to communicate effectively both verbally and in writing. - Strong listening skills. - Independent. - Responsible. - Self-disciplined. - Ability to meet defined performance and production goals. - Strong computer skills. - This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management. Certificate/License: - Minimum of one year of investigative experience is required. - Required to have one of the following: CPC, CCS, CCA Benefits - Medical, Dental & Vision insurance - 401(k) retirement savings with employer match - Vacation and sick paid time off - 7 paid holidays & 2 floating holidays - Paid maternity/paternity leave - Disability & Life insurance - Flexible Spending Account (FSA) - Employee Assistance Program (EAP) - Professional and career development initiatives - Remote work eligible REMOTE WORK REQUIREMENTS: - Must have high speed Internet (satellite is not allowed for this role) with a minimum speed of 25mbs download and 5mbs upload. Originally posted on Himalayas

Наблюдалась 2026-10-12, впервые 2026-10-12, источник — Himalayas (JSON API).

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