Top 9 Coding auditor Jobs in Franklin, Tn

Coding and Medical Records Auditor
TruHealth LLC —Franklin, TN
- Mid-level
- 2 years
Quick Apply
5d
Profee Coding Auditor
Parallon —Brentwood, TN
- Full-time
- Mid-level
- Organizational skills
- 2 years
- Employee stock purchase plan
- Disability insurance
Quick Apply
Inpatient Coding Auditor
Parallon —Nashville, TN
- Full-time
- Mid-level
- Employee stock purchase plan
- Disability insurance
Quick Apply

Discover related jobs

Based on your search for coding auditor jobs.

Home Health & Hospice Billing Lead (Hybrid)
Pennant Services —Nashville, TN
Associate's or Bachelor's degree in Business, Accounting, Finance, or a related field. Ensures all billing practices adhere strictly to CMS (Medicare), state…
Quick Apply
Director of Revenue Cycle - Professional Services
Summit Healthcare Mgmt —Franklin, TN
Maintain oversight of reconciliation processes, ensuring alignment between cash, EFT, lockbox, credit card, and manual payments with the general ledger and bank…
Quick Apply

Show more related jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Coding Auditing Supervisor - Remote
Mount Carmel —Columbus, OH
Ensure they understand what they own and are accountable for. Ensure staff understand expectations and have the tools to meet those expectations.

I want to receive the latest job alert for coding auditor in franklin, tn

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

coding auditor jobs near franklin, tn

Coding and Medical Records Auditor

TruHealth LLC -
Franklin, TN

Quick Apply

Job Details

5 days ago

Qualifications

Medicare
Managed care
Managed care organization experience
CMS
Regulatory compliance in claims processing
CDIP
Healthcare documentation compliance audits
Mid-level
RHIT
Incident Escalation
Certified Professional Coder
CMS regulatory compliance
Quality assurance audits
Retrospective medical coding audits
Internal employee customer service
Health insurance knowledge
Medicare regulations
Operative report review
Health information data integrity
System validation
Certified Coding Specialist
Centers for Medicare & Medicaid Services (CMS) billing regulations
Medicaid
Quality audits
Certified Risk Coder (CRC)
Data validation
Insurance claims auditing
CCDS
Clinical documentation standards
Healthcare claims compliance audits

Full Job Description

JOB SUMMARY:

TruHealth is the clinical arm of the health plan and supplies the model of care. The Coding and Medical Records Auditor will be
responsible for conducting coding audits prior to claims submission. This position will ensure appropriate and accurate coding is
applied for each member of the plan. Additionally, post-payment coding reviews may be performed with coding education
correspondence sent to providers

The Coding and Medical Records Auditor will be responsible for conducting coding audits prior to claims submission. This position will ensure appropriate and accurate coding is applied for each member of the plan. Additionally, post-payment coding reviews may be performed with coding education correspondence sent to providers.

ESSENTIAL JOB DUTIES:

To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.

Review claims prior to billing to provide a proactive level of accuracy.
Assess trends; communicate appropriate education both individually to staff and collectively as an organization.
Review medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries as needed to verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered.
Conduct pre-claim and post-claim coding audits to ensure accurate claims’ denials.
Work closely with delegated claim processor to ensure errors are reviewed and corrected prior to final payment.
Assist with validation audits to evaluate medical record documentation to ensure coding accurately reflects and supports relevant coding based on the ICD-10 code submitted to CMS and interpretation of medical documentation to ensure capture of all relevant coding based on CMS Hierarchical Condition Categories (HCC) conditions applicable to Medicare Risk Adjustment reimbursement initiatives.
Work assigned coding projects to completion.
Provide a high level of customer service to internal and external customers by consistently meeting and/or exceeding expectations including but not limited to quality and productivity.
Escalate appropriate coding audit issues to management as required and follow departmental/organizational policies and procedures.
Maintain required levels of production and quality standards as established by management.
Work directly with provider representatives and executive directors on Letters of Agreement (LOAs) to ensure appropriate coding methodology and reimbursement.
Ensure regulatory compliance and overall quality and efficiency by utilizing strong working knowledge of coding standards.
Follow all appropriate Federal and State regulatory requirements and guidelines applicable to Health Plan operations or as documented in company policies and procedures.
Participate in and support ad-hoc coding audits as needed.
Other duties as assigned

EXPERIENCE:

3 years HCC coding and/or coding and billing required
5 years HCC coding and/or coding and billing preferred
2+ years of complex claims processing and/or coding auditing experience in the health insurance industry or medical health care delivery system recommended.
2 + years of experience in managed healthcare environment related to claims’ and/or coding audits recommended.
2 year(s): Knowledge of standard coding and reference materials used in a claim setting, such as CPT4, ICD10, HCPCS and others
2 year(s): Knowledge of CMS requirements regarding claims processing and coding; especially Skilled Nursing Facility and other complex claim processing rules and regulations
2 year(s): Coding/auditing claims for Medicare and Medicaid plans.
2 year(s): Experience in managed healthcare environment related to coding audits
2 year(s): Complex claims processing and/or coding experience in the health insurance industry or medical health care delivery system

LICENSE/CERTIFICATION: REQUIRED (any of the following):

Certified Professional Coder (CPC)
Certified Risk Coder (CRC) · Certified Coding Specialist (CCS)
Certified Documentation Integrity Practitioner (CDIP)
Certified Clinical Documentation Specialist ( CCDS)
Registered Health Information Technician (RHIT)

Licenses & Certifications

Preferred

Medical Coding Cert

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

Quick Apply

Refine Your Search

coding auditor jobs in franklin, tn

Coding and Medical Records Auditor

Profee Coding Auditor

Inpatient Coding Auditor

Discover related jobs

Explore jobs in cities nearby

I want to receive the latest job alert for coding auditor in franklin, tn

Explore jobs in more locations

Licenses & Certifications

Job Seeker Tools

Employer Tools

Browse

Stay Connected