Medical Coder - Revenue Integrity Audit

• Performs Charge Reviews on the appropriateness of patient charges, and Charge Description Master (CDM) assigned HCPCS/CPT coding, by reviewing the medical record, facility protocol, and other applicable documentation. The reviews may include the verification of billing data for accuracy and completeness, following regulatory requirements, to resolve edits or exceptions detected during system processing of the claim in the customer systems
• Reviews that modifiers applied are appropriate based upon reviews, and/or makes necessary adjustments to patient account charges and/or balances
• Analyzes accounts for specialized billing requirements that require a review of the medical record documentation, regulatory information, and standards
• Evaluates if account combinations and account splits are appropriately applied
• Aggregates charge capture issues, clinical documentation issues and revenue education opportunities to help clinicians understand their documentation responsibilities
• Provides charge review results and presents findings to internal and client stakeholders
• Coordinates charge reviews for retrospective or concurrent, and other billing reviews as identified
• Reviews denial trends for documentation and missed charges/revenue opportunities and provides feedback on educational gaps

• Graduates in life sciences with 1 - 4 years of experience in Medical Coding
• 1-2 years audit experience
• Prior clinical and/or coding background preferred
• Experience in specialties such as Cardiology, Radiology, Pathology, Anesthesia, Emergency Room, Surgery, as well as in-patient settings
• Sound understanding of coding/billing process and typical issues leading to denials and missed charges
• Exposure to CPT-4, ICD-9, ICD-10, and HCPCS coding
• Good knowledge of medical coding and billing systems, regulatory requirements, auditing concepts, and principles

CCS/CPC/CPC-H/CIC/COC certification from AAPC /AHIMA would be a plus. Current Coding certification with valid proof of certifications would be needed

• Attractive Salary package
• Saturday and Sunday Fixed Off
• Other Benefits