A Coding Auditor assumes accountability for auditing diagnosis data that are collected from physicians and hospital medical records and ensures ICD-10 coding and compliance with risk adjustment requirements. A well-drafted Coding Auditor Resume mentions the following core duties and responsibilities – collecting and analyzing data to formulate recommendations and solutions based on audit trends, providing regular feedback to operations leadership, participating in and representing the department in business leadership groups; assessing and identifying training opportunities, maintaining current knowledge of requirements and guidance, and reviewing medical records that are coded and reviewed.
Qualifications needed to succeed in this career include – experience as a coder of medical records in a coding or insurance office setting; knowledge of medical terminologies, the ability to use appropriate software, and certified risk adjustment coder credentials. A high school diploma is commonly considered a minimum requirement.
Objective : Looking to obtain a position that will allow individual growth in a leadership role, while maintaining efficient and effective work habits in a challenging work environment.
Skills : Inpatient Coding, OP Coding, Speciality Coding.
Description :
Conducted audits for a multi-specialty group of over 50 providers on evaluation and management for clinic, hospital, home health, and nursing home services provided, as well surgical procedures.
Performed focused audits on providers that are not compliant with CMS documentation guidelines.
Provided individualized audit results and education.
Reviewed ADR and Cert Request.
Provided Shadowing in Clinic for documentation improvement.
Performed charge master audits using the OIG work plan as a guide.
Worked closely with the compliance department to ensure that all providers are compliant with CMS, OIG, and other federal regulations.
Experience
2-5 Years
Level
Junior
Education
Business And Management
Coding Auditor Resume
Objective : Seeks to achieve a position as a Medical Coder and/or related to the profession that would allow utilizing certification, experience, education, and knowledge that have acquired.
Skills : Completed ICD 10 Training Through AAPC. Extensive Knowledge.
Description :
Performed coding compliance audits of patient care billing documentation in accordance with Facey Medical Foundation's annual Compliance Work Plan, and prepare written and oral communication to the Coding Compliance Lead and Coding Compliance Coordinator on the results of audits performed.
Analyzed medical charts for completeness and codes diseases and operations for abstracts.
Audited records to ensure proper submission of services prior to billing on pre-determined selected charges.
Received hospital information to properly bill provider services for hospital patients.
Attended seminars and in-services as required to remain current on coding issues.
Provided coding training and communications to providers and third-party billing.
Notified medical staff of uniform billing practices, documentation problems, and coding strategies for maximum reimbursement.
Experience
2-5 Years
Level
Junior
Education
CCS Exam Prep
Coding Auditor Resume
Headline : Seeks to pursue an opportunity that allows using diverse expertise in the medical coding and billing field. To demonstrate strong work ethics combined with a commitment to excellence in job performance.
Skills : Knowledge Of Word, Excel, PowerPoint, EncoderPro, Eclinical Works, Ic-Chart, IDX, Claims Manager, And Reports, And Cerner PowerChart.
Description :
Responsible for assigning appropriate CPT, HCPCS, and diagnosis codes to claims for multi-specialty providers.
Responsible for posting charges to the billing system.
Assisted Claims Specialists in the prebill process to ensure accuracy of billed services prior to bill submission.
Researched, assisted, and followed up on claim denials.
Participated and performed monthly audits for Genesis Health System providers.
Assisted office staff/providers with coding, billing, and documentation-related issues.
Accurately and efficiently conducted medical record reviews for HEDIS HCC and RXHCC measures.
Experience
5-7 Years
Level
Executive
Education
Certificate In Evaluation & Management
Coding Auditor Resume
Headline : Coding Auditor is in charge of analyzing and auditing code for compliance with coding guidelines. The Coding Auditor is responsible for ensuring that all code complies with the company’s coding standards, in addition to following a set of best practices and guidelines. The Coding Auditor also ensures that the company’s code base is up-to-date and secure.
Skills : Auditing Skills, Consultant Skills.
Description :
Audited physician charts to comply with correct coding and documentation.
Coded Peripheral Vascular charts, emergency room charts, and NICU charts.
Consulted all departments on correct coding and documentation to be compliant.
Trained of the Cath Lab, Radiology, MRI, CT Scan, and pathology on coding and documentation.
Ensured that all quotas and assignments are completed in a timely fashion.
Edited and Re-coded as appropriate.
Provided assistance for technical coding navigation through AHLTA.
Experience
5-7 Years
Level
Executive
Education
Advanced Coding And HRM
Coding Auditor Resume
Summary : Coding Specialists are responsible for translating patients’ data into a special code format. These codes are used for billing, recordkeeping, and research. A well-written example resume for Coding Specialist should mention work responsibilities like extracting data from documents such as diagnosis forms, researching predetermined code lists, entering codes into computer applications, and clarifying information when needed.
Skills : Microsoft Word, Excel, Access, And PowerPoint All Versions Ingenix Encoder, Pro Tenet Cerner, Pdoc Systems, Mckesson, Meditech, Medhost 3M, Proficiency Data Entry.
Description :
Protected against fraudulent claims and billing activity.
Helped identify and correct problem areas before insurance or government payers challenge.
Audited HCC coding claims for accuracy and completeness.
Coded ER charts for professional and facility assigning E/M, diagnostic, procedural, injections.
Audited all medical claims prior to submission for reimbursement, query physicians for missing information, process payments from self-pay patients.
Processed within timely filing, AR was 28 days out.
Audited medical coder's work to ensure all HCCs are abstracted from the charts.
Experience
7-10 Years
Level
Management
Education
Medical Billing
Coding Auditor Resume
Summary : Currently seeking a position in Coding Auditor. Further, seeking employment with a company that will utilize experience and skills in HCC coding (Hierarchical Condition Categories).
Skills : Microsoft Office, Data Management.
Description :
Directed reviews and audits of outpatient services held for claims resolution and research.
Abstracted surgical codes for multiple specialties, as well as supported physicians with coding questions.
Provided one-on-one coaching and education in coding for clinical staff.
Processed medical records for In-Patient Coding in compliance with local, state, and Federal guidelines.
Researched and reviewed Medicaid guidelines and rules for each state in which an audit was performed.
Utilized data in Excel spreadsheets.
Performed concurrent ICD-10-CM/PCS and CPT coding analysis of medical records to validate code assignment.
Experience
7-10 Years
Level
Management
Education
HS
Coding Auditor Resume
Summary : Seeking a challenging position in a healthcare environment that would enable using experience, training, education, and ability in making a positive contribution to the healthcare industry.
Skills : ICD-9, ICD-10, CPC.
Description :
Reviewed multi-specialty encounters in all settings for all lines of business to ensure accurate ICD-9-CM.
Audited physician journals for compliance within the deadline.
Query physicians to correct deficiencies in documentation.
Multispecialty outpatient coding.
Corrected back-end errors and resolving edits.
Worked closely with the clinic coders and clinic managers to ensure consistency with documentation.
Assisted with denials, reviewing documentation for appeal.
Experience
7-10 Years
Level
Management
Education
HS
Coding Auditor Resume
Summary : Coding Auditor is responsible for auditing coding and quality of code produced by the software engineering team. The Coding Auditor will conduct code reviews, identify and report defects, track code changes, maintain a defect tracking system, and participate in code reviews for new features.
Skills : PowerPoint all Versions, Ingenix, Encoder Pro, Tenet Cerner. Pdoc Systems, Mckesson, Meditech, Medhost 3M, Coderyte Epic PremiEHR PC Proficiency Data Entry.
Description :
Performed new provider orientation, teaching billing, and coding.
Utilized the documentation guidelines, along with payer-specific information and the CMS internet-only manuals.
Educated on fraud and abuse using the OIG's Roadmap for New Physicians.
Identified risks and taking appropriate action.
Responsible for validating Neoplasm and other ICD-9 codes submitted in outpatient.
Abstracted HCC codes may not have submitted by physicians.
Abstracted HCC's from Inpatient/Outpatient records.
Experience
7-10 Years
Level
Management
Education
Advanced Coding and HRM
Coding Auditor Resume
Summary : Coding Auditor is responsible for coding review and feedback of code written by the software developers. The Coding Auditor also works closely with developers to help them understand their code and identify potential issues before they are introduced in production.
Skills : Patient Care, MS office.
Description :
Scheduled chart reviews in the Metro.
Responsible for helping co-workers with any questions and reviewing several of their encounters per week and keeping a spreadsheet of theirs.
Inpatient reviewed criteria may include: principal and secondary diagnosis code (accuracy, omission, etc.), Diagnosis Related Groups accuracy, correct Present on Admission assignment.
Contracted shall have a methodology for resolving coding questions by reviewers and ensuring inter-reviewer consistency and reliability.
Applied Official Guidelines for Coding and Reporting consistently and appropriately.
Provided written explanations to support or rebut audit recommendations.
Demonstrated working knowledge of all facets of role, relevant regulations, and organizational and departmental policies and procedures.
Experience
7-10 Years
Level
Management
Education
Advanced Coding and HRM
Coding Auditor Resume
Summary : Coding Auditor is responsible for reviewing software code in order to identify and fix coding issues. The Coding Auditor should be able to understand the requirements of the software and create a plan for testing and verifying that the code meets those requirements.
Skills : Implementational Skills, Patient Care.
Description :
Reviewed Patient Account Representative's daily coding journals from several MFI clinics.
Participated in required training.
Abstracted diagnosis from inpatient and outpatient charts for Medicare HCC Coding.
Multitasked and troubleshoot problems independently.
Encountered/quartered are identified by billed episode and then audited against these three criteria. If the encounter does not have a Common Procedural Terminology procedure code associated with the visit, then that data point is not audited.
Determined the accuracy and sequencing of the diagnoses coded and identify the reason(s) if not.
Determined the accuracy of Common Procedural Terminology/Healthcare Common Procedural Coding System codes and modifiers and the reason(s) if not accurate.
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