STAR Medical Auditing Services is a boutique consulting firm that provides Health Information Management (HIM) and Clinical services to various organizations in the healthcare ecosystem across the U.S. We pride ourselves in providing high-quality services that are tailored to our clients’ specific needs, while creating joyful experiences along the way by treating everyone with respect and care.
Must reside and be legal to work in the U.S.
Overview:
As a Behavioral Health Medical Coding Auditor for STAR, you will be responsible for reviewing medical records and coded data to ensure accuracy, compliance, and adherence to federal regulations and payer guidelines. This role identifies coding discrepancies, supports revenue integrity, and provides educational feedback. Auditors joining STAR are expected to already possess the foundational skills required for auditing, including a strong proficiency in and understanding of Official Coding Guidelines with at least 3 years of auditing experience. Will be required to complete skills assessment to be considered for position.
Essential Duties and Responsibilities:
- Reviews medical records to identify diagnoses, CPT procedures and modifiers relative to the patient’s encounter for Behavioral health services
- Abstracts appropriate information from the medical record based on the guidelines provided by the client and after a thorough review of the medical record.
- Solicits clarification from the physician regarding ambiguous or conflicting documentation in the medical record using guidelines provided by the client.
- Ensure all coding complies with the ethical coding standards/guidelines and regulatory requirements.
- Stay current on coding guidelines
- Communicates identified errors with thorough rationales including citing guidelines and sources
- Maintains strictest confidentiality; adheres to all Health Insurance Portability and Accountability Act guidelines/regulations
- Attend mandatory meetings as needed
Education and/or Work Experience Requirements:
- Must have one of the following AHIMA/AAPC certifications: CPC, CCS, RHIA, RHIT
- Extensive knowledge of medical terminology, anatomy and coding guidelines for ICD-10, CPT and Modifiers.
- At least 3 years of recent active Behavioral Health auditing experience in:
- Evaluation & Management Services
- CPT Coding
- Modifier usage
- NCCI Edits
- Knowledge of current and developing issues, trends in medical coding procedures requirements, and be able to research as needed
- Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures, and documentation including CMS guidelines
- Proficient computer skills using MS-Word, Excel, Outlook, Internet Explorer, electronic medical records (EMR) systems.
- Meet required client productivity standards and maintain minimum of 97% accuracy
- Self-sufficient with strong analytical and research skills
- Responsible and responsive
- Strong attention to detail
- Excellent written and oral communication skills
- Ability to meet deadlines
- Able to commit to 40 hours per week
- Able to start in 2 weeks or less
- Must reside and be legal to work in the U.S.
Physical Requirements:
- Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
- Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards
Segregation of Duties
Every employee is responsible to perform their duties and responsibilities in accordance with STAR’s values, policies and procedures, including but not limited to, Segregation of Duties Principles, HIPAA Security and Privacy, and any other applicable laws, rules and regulations.
Statement of Other Duties
This document outlines the essential functions, requirements, and responsibilities of the position, and is not intended to be a complete list of all tasks and duties. Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or by management.
Pay: $28.00 - $30.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Flexible schedule
- Flexible spending account
- Health insurance
- Health savings account
- Paid time off
- Parental leave
- Professional development assistance
- Referral program
- Vision insurance
Application Question(s):
- Can you commit to 40 hours per week?
- Are you willing to commit to completing skills assessment within 2 days of receipt?
- What date are you available to start?
- Is your coding credential active (not expired)?
Experience:
- recent Behavioral Health auditing: 3 years (Required)
License/Certification:
- CPC or CCS credential? (Required)
Work Location: Remote
