Senior Compliance Coding Auditor CH (REMOTE)

Knowledge, Skills and Abilities

• Advanced knowledge and demonstrated proficiency in the application of ICD-10-CM, CPT®, and HCPCS Level II coding guidelines, conventions, and regulatory requirements.
• Extensive knowledge of medical terminology, anatomy and physiology, disease processes, pharmacology, and clinical documentation requirements.
• Thorough understanding of Centers for Medicare & Medicaid Services (CMS) regulations, National Correct Coding Initiative (NCCI) edits, Office of Inspector General (OIG) compliance guidance, Medicare and Medicaid policies, and applicable payer-specific coding and billing requirements.
• Strong knowledge of healthcare compliance programs, auditing methodologies, reimbursement principles, and revenue integrity practices.
• Demonstrated ability to conduct complex coding and documentation audits, identify compliance risks, determine root causes, and recommend corrective actions.
• Ability to analyze coding, billing, and audit data; identify trends and patterns; and develop actionable recommendations for process improvement and risk mitigation
• Strong critical thinking, analytical, problem-solving, and decision-making skills.
• Exceptional attention to detail, accuracy, and organizational skills, with the ability to manage multiple priorities and meet deadlines.
• Excellent verbal, written, presentation, and interpersonal communication skills, including the ability to educate providers, leadership, and staff on coding, documentation, and compliance requirements.
• Proficiency in Microsoft Office Suite, including advanced Excel skills for data analysis and reporting.
• Experience utilizing electronic health records (EHRs), coding systems, auditing software, and compliance monitoring tools.
• Ability to collaborate effectively with clinical, operational, revenue cycle, and compliance stakeholders to support organizational compliance and revenue integrity objectives.
• Ability to interpret and apply evolving regulatory guidance, coding updates, and industry best practices to ensure organizational compliance and revenue integrity.

Education

Required Work Experience

Require License and Ceritifcations