Certified Medical Coding Auditor

Medusind is a leading provider of revenue cycle management solutions to dental, behavioral health, anesthesia, pathology, emergency, surgery, radiology, and other specialties. In January 2023, Alpine Investors, a people-driven private equity firm, invested in Medusind to continue to advance its leadership position as one of the top revenue cycle management companies in the country.

Position Overview

The Certified Coder ensures all collected data is accurate, complete and compliant with state and federal regulations as well as Official Guidelines for Coding and Reporting. This position ensures that all encounters are coded, abstracted and finalized accurately and in accordance with defined service level agreements.

In this role, you'll be collaborating with an innovative team of people, moving exciting projects forward and working to improve systems and processes along the way for various types of specialties including FQHC, CHC, Behavioral health, Dental, etc.

Key Responsibilities

Audit Medical Records:

• Review and ensure medical codes are correctly applied to patient records for reimbursement.
• Perform regular coding audits to ensure compliance with payer guidelines, government regulations, and industry standards.
  
  

Problem Resolution

• Identify and resolve discrepancies, and address any inconsistencies or errors in medical documentation and coding.
• Examine any medical malpractice that has been reported by analyzing and identifying the medical procedures, diagnoses or events that lead to negligence.
  
  

Reporting And Analytics

• Compile detailed reports on audit findings, presenting recommendations for improvements to enhance coding accuracy and efficiency.
  
  

Continuous Improvement

• Stay up-to date on the latest coding changes, updates to payer requirements, and healthcare industry trends to maintain a competitive edge.
• Contribute to the internal process documentation and training material.
  
  

Requirements

Educational Background: High School Diploma or GED

Experience: At least 2 years’ experience, Certified Professional Coder Certification (CPC) -Required, Certified Professional Medical Auditor (CPMA) – Required, FQHC billing experience – preferred.

Expert Industry Knowledge: Demonstrates experience and a proven track record in Coding in a facility of significant size and complexity, information systems, and coding applications, as typically acquired in 1 year of experience performing FQHC, outpatient coding.

Communication & Collaboration: Strong ability to collaborate with cross-functional teams, including physicians, coders and billing teams to address discrepancies and enhance overall operational efficiency.

Detail-Oriented: High level of accuracy, with the ability to set and maintain priorities in a fast-paced environment.

Technical skills: Experience with billing software, data analytics, and process improvement initiatives. Leveraging technology and automation to enhance efficiency and accuracy.

Adaptability and flexibility: Should be able to adapt to changes in regulations, technologies, and industry trends and adjust accordingly.

About Medusind

Since 2002, organizations across the entire healthcare spectrum have leveraged our deep expertise and high-quality solutions to maximize revenue, reduce operating costs and navigate the changing healthcare landscape.Medusind’s unique combination of deep industry expertise, robust operational capability, and client-focused service significantly improves the efficiency and profitability of healthcare organizations. Client satisfaction is the primary focus of the Medusind leadership and staff.Our highly experienced personnel, cutting edge technology, and forward thinking approach allows us to deliver effective solutions while staying ahead of healthcare industry changes.