Quality Auditor
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Job Description
Quality Auditor responsible for auditing multispecialty medical coding against standards and providing feedback. Vee Healthtek transforms healthcare organizations with cutting-edge solutions.
Responsibilities:
- Conduct routine and focused coding audits across multiple medical specialties (e.g., cardiology, orthopedics, general surgery, gastroenterology, radiology, internal medicine, etc.).
- Review CPT®, ICD-10-CM, and HCPCS Level II coding for accuracy, completeness, and compliance with CMS, OIG, and payer-specific rules.
- Evaluate medical record documentation to ensure accurate code assignment and adherence to medical necessity and coding guidelines.
- Identify trends, patterns, and recurring coding errors; collaborate with coders and leadership to implement corrective actions.
- Prepare detailed audit reports summarizing findings, accuracy rates, and recommendations for improvement.
- Provide one-on-one or group coder education and feedback based on audit outcomes.
- Assist in the development and maintenance of internal audit tools, policies, and training materials.
- Stay current on coding updates, compliance regulations, and industry best practices.
- Participate in internal compliance reviews and support external audits as needed.
- Contribute to process improvement initiatives that enhance coding quality and operational efficiency.
Requirements:
- Associate’s or Bachelor’s degree in Health Information Management, Health Administration, or a related field (preferred).
- Active coding certification required: CPC, COC, or CCS (AAPC or AHIMA).
- CPMA (Certified Professional Medical Auditor) or equivalent auditing credential strongly preferred.
- Additional specialty credentials (e.g., CIRCC, CDEO, or CCS-P) are advantageous.
- Minimum 5 years of experience in professional or facility coding across multiple specialties.
- Minimum 2 years of experience in coding auditing or quality review preferred.
- Strong understanding of CPT®, ICD-10-CM, and HCPCS Level II coding systems and payer guidelines.
- Experience with EHRs and coding/audit software tools (e.g., 3M, Epic, Optum, or similar).
Benefits:
- Full health insurance including medical/dental/vision
- PTO
- 401k match
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