Remote Medical Coding Auditor

Currently recruiting an REMOTE Medical Coding Auditor to provide support to Active Duty heroes, their families, and retirees.The full-time position is Monday-Friday, 8 hours shifts between 7:30am and 4:30pm.DUTIES OF THE MEDICAL CODING AUDITOR:Verifies the accuracy of the diagnosis, procedure, supply codes, modifiers, and sequencing for the professional and institutional (facility) components of inpatient, ambulatory, and outpatient encounters.Provides second-level review of coding assignment to ensure compliance with legal and procedural policies to ensure optimal reimbursements while adhering to regulation prohibiting unbundling and other questionable practices.Examines records for proper sequence of documents, presence of authorized signatures, and sufficient data is documented that supports diagnosis, treatment administered, and results obtained.When assigned to perform Data Quality Management Control (DQMC) audits, provides each assigned MTF with coding audit accuracy data needed to complete their monthly Data Quality Review List/Statement and collaborate on the explanation and action plan to correct any measures not meeting performance standards IAW DHA-MCPB policies, procedures, rules, and standards.Develops or executes focused or specific audits related to medical coding and documentation IAW DHA-MCPB direction, guidance, instructions, policies, and procedures.Reviews encounter and/or record documentation to identify and resolve inconsistencies, ambiguities, or discrepancies that may cause inaccurate coding, medico-legal repercussions or impacts quality patient care.Identifies any problems with legibility, abbreviations, etc., and brings to the provider s attention.Educates and provides feedback to providers and clinical staff to resolve documentation issues to support coding compliance.Acts as a source of reference to medical staff having questions, issues, or concerns related to coding.Responds to provider questions and provides examples of appropriate coding and documentation reference(s) to provide clarity and understanding.Collaborates with and supports medical coders, trainers, and compliance specialists in providing education and feedback to providers and staff.Supports DHA coding compliance by performing due diligence in ethically and appropriately researching and/or interpreting existing guidance, including seeking clarification through appropriate channels.Stays abreast of changes in Federal laws, Department of Health and Human Services Office of Inspector General (HHS-OIG), DoD, and DHA regulations, and commercial policies involving or affecting compliance.Achieve and maintain DHA auditing productivity and accuracy standards for the position.QUALIFICATIONS OF THE MEDICAL CODING AUDITOR:Education:Post-high school education through a university or technical school program resulting in completion of ONE of the following:1) An Associate s degree or higher in Health Information Management, Healthcare Administration, or a biological science;OR2) A university certificate in medical coding;OR 3) At least 30 semester hours university/college credit that includes relevant coursework such as anatomy/physiology, medical terminology, health information management, and/or pharmacology;OR 4) Successful completion of an American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) coding certification preparation course for professional services or facility coding that includes medical terminology, anatomy and physiology, health information management concepts, and pharmacology;OR 5) Successful completion of a training course beyond apprentice level for medical technicians, hospital corpsmen, medical service specialists, or hospital training, obtained in a training program given by the Armed Forces or the U.S.Maritime Service under close medical and professional supervision.Certification:ONE of the following recognized professional coding certifications:Certified Professional Coder (CPC)Registered Health Information Technician (RHIT)Registered Health Information Administrator (RHIA), or Certified Coding Specialist Physician (CCS-P);AND ONE of the following recognized institutional coding certifications:Certified Inpatient Coder (CIC), Registered Health Information Technician (RHIT)Registered Health Information Administrator (RHIA)Certified Coding Specialist (CCS);AND the following auditing certifications:Certified Professional Medical Auditor (CPMA) AND the National Alliance of Medical Auditing Specialists (NAMAS) Certified Evaluation and Management Auditor (CEMA).Must be a U.S.Citizen (for access to Government computer systems)COMPENSATION & BENEFITS FOR THE MEDICAL CODING AUDITOR:Competitive pay10 days paid time off per year plus 7 sick days per year11 paid Federal holidays Health & Welfare allowance mostly covers the cost of health insurance, long and short-term disability, and life insuranceDental and vision plans offered, 401(k). Salary: USD 72000 - 108000 per year