SCIO Health Analytics/EXL Company is looking for Auditor I – Outpatient Coding temps for our Jacksonville, FL location with the possibility of a Remote - Home Office opportunity.
The responsibilities of the Outpatient Coding Auditor are to perform reviews by validating accuracy of the coding billed in relation to the medical documentation. The coding auditor determines if a discrepancy exists in the coding and documents the findings using standard documentation guidelines applicable to the program. The audits may be performed as desk or as a facility onsite. The coding auditor may need to travel to the providers location on an agreed upon schedule and perform the audit review.
- Must have the ability to code a wide variety of complex outpatient services such as interventional radiology, ambulatory surgery, emergency room and observation. Reviews medical records to determine if facility coding is accurate.
- Proficient in modifier application following appropriate Medicare and NCCI guidelines
- Adheres to department standards for productivity and accuracy.
- Ability to write professional notes based quoting resources of Official Coding guidelines, ICD-10 Coding Handbook, Coding Clinic and/or other recognized sources.
- Review appeal information and render coding decision to either uphold or overturn original finding
- Must have thorough understanding of ICD-10 Coding; HCPCS/CPT coding systems; Medicare Outpatient Prospective Payment System (OPPS), and Ambulatory Payment Classification (APC)
- High School Diploma
- CPC from AAPC or CCS from AHIMA Certified
- Minimum 3 years coding experience: Professional and hospital coding
- Excellent verbal and written communication skills
- Ability to work from office if in the Jacksonville, Florida area.
Knowledge and Skills:
- Experience with: Excel, PowerPoint, Outlook, and Word
- Experience with Encoder tools (Optum, TrueCode, 3M, Webstrat)
- Sound knowledge of ICD procedure codes, CPT and HCPCS coding guidelines.
- Experience with and expertise with Medicare Local Coverage Determinations (LCD) and National Coverage Determinations (NCD)