Job Description
Performs complex coding audits, drafts findings and advises with organization leadership to provide education on regulations and mitigate compliance risk.
Job Responsibility
- Reviews data, such as claims detail, coding and medical record documentation to determine compliance with appropriate coding and documentation requirements.
- Drafts reports detailing coding audit findings.
- Assists with billing/documentation and regulatory risk assessments.
- Acts as the internal expert on coding issues to ensure compliance with state and federal regulations.
- Research, interpret and communicate federal and state laws and guidelines pertaining to Medicare and NYS Medicaid.
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Job Qualification
- Bachelor's Degree required, or equivalent combination of education and related experience.
- Current Professional Coder Certification, or Current Coding Professional Certification required, plus specialized certifications as needed.
- 3-5 years of relevant experience, required.
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).