Coding Auditor, Outpatient Facility and Professional Services
Welcome to Optum, where we are dedicated to making the healthcare system work better for everyone. We are currently seeking a Coding Auditor for our Outpatient Facility and Professional Services team to ensure accurate and compliant coding practices. In this role, you will play a crucial part in improving the overall efficiency and quality of our coding processes. We are looking for a detail-oriented and experienced individual with a deep understanding of coding guidelines and regulations. If you are passionate about healthcare and have a strong desire to make a positive impact, we want to hear from you.
- Conduct audits of outpatient facility and professional services coding to ensure accuracy and compliance with coding guidelines and regulations.
- Identify and report any potential coding errors or discrepancies.
- Collaborate with coding and billing teams to address and resolve coding issues.
- Stay up-to-date on coding guidelines and regulations and communicate any changes or updates to the team.
- Provide feedback and training to coding team members to improve coding accuracy and efficiency.
- Develop and implement coding policies and procedures to maintain compliance.
- Analyze coding data to identify trends and areas for improvement.
- Participate in coding compliance reviews and assist in developing corrective action plans.
- Assist in responding to coding-related inquiries and appeals.
- Maintain confidentiality and adhere to all HIPAA regulations.
- Contribute to the overall success of the coding team and the organization's mission of improving the healthcare system.
- Act as a resource and subject matter expert on coding guidelines and regulations for the team.
- Continuously seek opportunities for process improvement and efficiency in coding practices.
- Maintain accurate and organized documentation related to coding audits and findings.
- Attend trainings and conferences to stay current on coding best practices and industry updates.
Knowledge Of Coding Guidelines: A Qualified Coding Auditor Should Have A Thorough Understanding Of Coding Guidelines, Such As Icd-10-Cm, Cpt, And Hcpcs, To Accurately Review And Audit Outpatient Facility And Professional Service Claims.
Experience In Outpatient Facility And Professional Services Coding: The Ideal Candidate Should Have At Least 3-5 Years Of Experience In Coding For Outpatient Facilities And Professional Services, With A Strong Knowledge Of Common Coding Errors And Compliance Issues.
Strong Analytical And Critical Thinking Skills: As A Coding Auditor, One Should Possess Strong Analytical And Critical Thinking Skills To Identify Discrepancies And Potential Coding Errors In Claims Data.
Certification In Coding: A Coding Certification Such As Cpc (Certified Professional Coder) Or Ccs (Certified Coding Specialist) Is Preferred For This Role, Demonstrating A Thorough Understanding Of Medical Coding Principles And Practices.
Familiarity With E/M Guidelines And Documentation: Since Evaluation And Management (E/M) Services Are Commonly Audited In Outpatient And Professional Services, The Candidate Should Have A Strong Knowledge Of E/M Guidelines And Documentation Requirements To Accurately Review And Audit Claims.
Quality Assurance
Data Analysis
Auditing
Medical coding
Documentation review
Compliance monitoring
Claim
Denial Management
Coding Guidelines
Payment Variance Analysis
Reimbursement Methodologies
Communication
Conflict Resolution
Emotional Intelligence
Leadership
Time management
creativity
Attention to detail
Teamwork
Adaptability
Problem-Solving
According to JobzMall, the average salary range for a Coding Auditor, Outpatient Facility and Professional Services in Eden Prairie, MN, USA is $65,000-$90,000 per year. This range can vary depending on factors such as experience, education, and specific job responsibilities. Some employers may also offer additional benefits and incentives, such as bonuses or healthcare benefits.
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Since 1992, HealthCare Partners has been committed to developing innovative models of healthcare delivery that improve our patients' quality of life while containing healthcare costs. Our strength is in our steadfast commitment to our guiding principle of coordinated care. Our physicians strive daily to bring the benefits of coordinated care to more than 600,000 managed care patients in California, who represent the diversity of cultures, socioeconomic groups, ages, and health statuses in the communities we serve.
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