Ancillary Auditor II
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Job Description
Coding Auditor conducting quality and clinical coding compliance audits for BCBST. Identifying improvement opportunities and engaging in investigations for claims fraud.
Responsibilities:
- Conducting claims audits and serving as subject matter expert to management and internal or external stakeholders
- Presenting and communicating audit results to appropriate parties; recommending corrective course of action.
- Planning and conducting investigations for certain claims; identifying potential subrogation or fraud and engaging special investigate unit as needed.
- Providing technical and consulting support/training for quality and compliance audits.
Requirements:
- Bachelor's Degree or equivalent work experience required
- 4 years of professional/ancillary or facility inpatient/outpatient coding and/or auditing experience in an applicable setting
- Current AHIMA or AAPC coding certification of CPC or equivalent for Professional Ancillary Audit team and CCS or equivalent for Facility Audit team required
- Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
Benefits:
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development
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