Facility Coding Auditor
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Job Description
ASC coding auditor reviewing medical records and coding data for healthcare facilities. Identifying compliance risks, reducing denials, and improving reimbursement accuracy.
Responsibilities:
- Conduct detailed audits of medical records and coding data from ASC procedures to ensure accuracy and compliance with ICD-10, CPT, and HCPCS coding standards
- Identify and document coding errors, inconsistencies, and potential compliance risks, providing clear and constructive feedback to coding staff and clinical teams
- Collaborate with billing, compliance, and clinical departments to resolve coding discrepancies and support corrective action plans
- Stay current with changes in coding guidelines, payer policies, and healthcare regulations to ensure audit practices reflect the latest standards
- Prepare comprehensive audit reports and present findings to management, recommending process improvements to enhance coding accuracy and reimbursement outcomes
Requirements:
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) credential
- Minimum of 5 years of experience in medical coding, preferably within an Ambulatory Surgery Center or similar outpatient setting
- Strong knowledge of ICD-10-CM, CPT, and HCPCS coding systems and guidelines
- Familiarity with healthcare compliance regulations including HIPAA and the False Claims Act
- Proficiency in using electronic health records (EHR) and coding audit software
- Preferred: Certified Coding Auditor (CCA) or Certified Inpatient Coder (CIC) certification
- Preferred: Experience with ASC billing and reimbursement processes
- Preferred: Background in healthcare quality assurance or compliance auditing
- Preferred: Advanced knowledge of payer-specific coding and billing requirements
- Preferred: Strong analytical skills with experience in data analysis and reporting tools
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