Senior Coding – Auditor | India

Advantum Health Logo

2+ years

Not Disclosed

Remote

10 Nov. 13, 2024

Job Description

Job Type: Full Time Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Job Title: Coding Auditor and Educator (Orthopedic Surgery)
Job Summary:
The Coding Auditor and Educator is responsible for auditing complex coding and billing practices, ensuring compliance with current coding guidelines, Medicare, medical necessity, and NCD/LCD requirements. This role primarily focuses on orthopedic surgery and E/M coding, with expertise in multiple specialties. The individual will provide educational training and support to physicians, mid-level practitioners, clinical staff, and revenue cycle teams. Strong communication skills are essential to confidently liaise with providers and clinical teams.

Qualifications:

Graduate in Lifesciences with coding certifications (CPC, CCS).
Minimum of 6 years of relevant coding experience and 8 years overall experience.
3+ years of experience in orthopedic surgery and Evaluation and Management (E/M) coding; experience in other surgical specialties is considered.
Certified coding certification from AAPC or AHIMA is required.
Deep understanding of auditing for compliance with 1995, 1997, and 2021/2023 E/M Guidelines.
Additional certifications such as RHIT, CCS, CPMA, or specialty designations are desirable.
Strong knowledge of physician financial reimbursement and revenue cycle management.
Experience in presenting coding audits and educational content to physicians and healthcare providers.
Ability to work in a high-volume, fast-paced coding audit environment, ensuring accuracy and high-quality deliverables (5-7 encounters per hour).
Proficient in Microsoft Office (Word, Excel) and multiple practice management systems.
Excellent communication skills (both verbal and written).
Strong project management skills and a proactive approach to continuous improvement.

Responsibilities:

Conduct regular audits of coding and billing practices, ensuring compliance with regulations and identifying areas for improvement.
Prepare clear, accurate audit findings and recommendations in written reports to educate providers, coders, and management.
Review medical records monthly to verify the accuracy of documented diagnoses and procedures, including ICD-10 CM codes, CPT, HCPCS, modifiers, and place of service.
Stay updated on changes in coding regulations, policies, and procedures to maintain organizational compliance.
Design, develop, and implement coding education programs for clients and staff.
Train and educate coding staff, physicians, and healthcare providers on coding best practices, documentation requirements, and compliance with regulatory guidelines.
Ensure HIPAA compliance while handling Protected Health Information (PHI).

Job Type:

Full-time

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Senior Coding – Auditor | India

Job Description

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