Job Details

Job Title: Compliance Auditing Specialist - Remote/Hybrid Available

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Job Summary: Serves as an internal expert on Risk Adjustment and Hierarchical Conditions Categories (HCC) coding. Responsibilities include performing concurrent and retrospective reviews of documentation and coding, working with providers and staff to ensure accuracy and completeness of medical record documentation and coding, and providing training, education, and coaching to ensure compliance with standards.

Responsibilities:

1. Audit medical records to ensure compliance with coding and documentation standards.
2. Manage query processes to identify and address inaccurate documentation or coding.
3. Compile data to identify areas for documentation and coding improvement.
4. Monitor and report on key performance indicators related to clinical documentation and HCC coding.
5. Maintain records of audits, queries, and educational efforts; track and report on program effectiveness.
6. Stay current with clinical documentation improvement and coding standards through continuing education.
7. Assist with compliance audits and other duties as needed.
8. Promote appropriate documentation through interaction with physicians, nursing staff, and other caregivers.
9. Serve as a resource for documentation and coding; develop and monitor procedures supporting organizational goals.

Qualifications/Requirements:

• Approximately 3 years of experience in clinical documentation improvement related to HCC coding in the ambulatory setting.
• Credentials such as CRC, CPC, CPMA, or CCDS.
• Bachelor's Degree in a related field.
• Remote/Hybrid work availability.

Additional Details:

• Seniority Level: Mid-Senior level
• Employment Type: Full-time
• Job Function: Finance and Sales
• Industry: Hospitals and Health Care