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Sr. Medical Coding Auditor (REMOTE NATIONWIDE)

Company: Lumeris
Location: Newark
Posted on: June 9, 2021

Job Description:

In order to apply for a position at Lumeris, you must create an account using your email address and a password of your choosing. This account will allow you to receive notifications each step of the way through the job application process. With these updates, you'll never have to wonder where you are in the process. Additionally, we can easily send pertinent documents to you for your review. Once you create the account, you may apply to any position you feel is a good fit without having to re-enter information. Thank you for your interest in Lumeris.

Position:

Sr. Medical Coding Auditor (REMOTE NATIONWIDE)

Position Summary:

The Senior Medical Coding Auditor will work with our Manager, Medical Coding to perform both internal and external audits. Actively involved in auditing all functions and services related to medical coding, medical documentation, and physician queries. Monitors coding and abstracting quality by conducting ongoing audits to ensure coding quality and performance improvement standards are maintained, achieved and improved. Ensures compliance with all applicable federal, state and local regulations, as well as with institutional/organizational standards, practices, policies and procedures.

Job Description:

Primary Responsibilities

  • Participates in development of provider/department performance reports and identifies opportunities for improvement
  • Interprets medical information such as diseases, conditions, or symptoms, and diagnostic descriptions and procedures for a given visit in order to accurately assign and sequence the correct ICD-10-CM.
  • Validates provider diagnosis coding for accuracy by reviewing of coding documentation and claims extract compared to actual medical records.
  • Reviews and identifies trends in coding discrepancies and notifies applicable department for training and education. May notify team members directly and individually via e-mail or telephone of instances where serious deficiencies necessitate focused reviews.
  • Supports management with issues/questions/problems which may arise.
  • Confidently communicates with physicians or other departments for discussion of diagnoses and risk adjustment coding. Clearly expresses information to individual or groups effectively, taking into account the audience and nature of the information.
  • Understands, supports, enforces and complies with company policies, procedures and Standards of Business Ethics and Conduct.
  • Displays a positive attitude as well as professional, polite, considerate and courteous conduct and treatment of others in the course of duties.
  • Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection.
  • Provides verbal and written reports of the results of coding audits, to include

recommendations for corrective action and improved accuracy.

  • Provides coverage for other compliance disciplines and completes other duties as assigned.

Qualifications

  • Bachelor's degree and Medical coding certification through either AAPC or AHIMA
  • Must obtain an AAPC Certified Risk Adjustment Coder certification within 12 months of employment
  • 5+ years of experience working in medical coding/auditing with experience in ICD-10-CM HCC diagnosis coding with at least 2+ years of experience performing as a team lead
  • Strong research skills including knowledge of automated analysis tools and on line research tools required to resolve complex coding/systems issues
  • Proficient with business applications like Microsoft Office, Adobe, etc.
  • Ability to work independently in a fast-paced environment with competing priorities
  • Demonstrated ability to communicate effectively through both written and verbal modalities
  • Experience working with Electronic Medical Record systems like Epic, Cerner, etc. strongly preferred
  • Remote work allowed.

Working Conditions

  • While performing the duties of this job, the employee works in normal office working conditions.

Disclaimer

  • The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.

Lumeris is an EEO/AA employer M/F/V/D.

Location:

Addison, TX, Addison, TX, Ann Arbor, MI, Apollo Beach, FL, Arlington, TX, Atlanta, GA, Austin, TX, Baltimore, MD, Barrow, GA, Bartow, FL, Baton Rouge, LA, Boston, MA, Brandon, FL, Braselton, GA, Charlotte, NC, Chicago, IL, Clearwater, FL, Columbus, OH, Dade City, FL, Dallas, TX, Dayton, OH, Denver, CO, Detroit, MI, Durham, NC, Edison, NJ {+ 34 more}

Time Type:

Full time

Keywords: Lumeris, Newark , Sr. Medical Coding Auditor (REMOTE NATIONWIDE), Other , Newark, New Jersey

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