Auditor Clinical Validation OPSP Coding

Why consider this job opportunity

• Salary up to $45.67/hour (approximately $95,000 annually)
• Eligible for discretionary bonus consideration
• Comprehensive benefits package including medical, dental, vision, and life insurance
• Generous Paid Time Off (PTO) policy with 17-27 days per year, depending on service
• Opportunity for career advancement within a leading healthcare auditing organization
• Flexible remote work environment

• Conduct audits of outpatient and specialty claims, ensuring coding accuracy and medical necessity
• Utilize advanced coding expertise and audit tools to substantiate findings and identify potential billing issues
• Maintain productivity and quality standards as set by the auditing concept
• Identify new claim types and suggest process improvements to enhance audit efficiency
• Complete special projects and additional duties as assigned on an annual performance plan

• Associate or bachelor’s degree in Health Information Management (RHIA or RHIT) or equivalent work experience
• Required coding certification (e.g., CPC, CIC, CCS, CCS-P, RHIA, or RHIT)
• 5 to 7 years of experience in clinical medical record coding or auditing
• In-depth knowledge of HIPAA Privacy and Security Rules and CMS security requirements
• Excellent verbal and written communication skills

• Familiarity with medical claims billing/payment systems and payer reimbursement policies
• Desire to learn and become proficient in various outpatient and specialty review types
• Adherence to official coding guidelines and regulatory compliance mandates

#Healthcare Auditing #Remote Work #Career Growth #Competitive Compensation #Flexible Benefits

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