Reaching out to those in need is more than a career; it's a calling.

If you share our philosophy, come share our success and exceptional growth potential. We are looking for engaged, talented people to join the HarmonyCares (formerly USMM) family of companies.

Why You Should Want to Work with Us

• Health, Dental, Vision, Disability & Life Insurance, and much more
• 401K Retirement Plan (with company match)
• Tuition, Professional License and Certification Reimbursement
• Paid Time Off, Holidays and Volunteer Time
• Paid Orientation and Training
• Great Place to Work Certified
• Established in 11 states
• Largest home-based primary care practice in the US for over 28 years, making a huge impact in healthcare today!

Position Description

The Medical Coding Auditor is to perform quality assurance audits on Medical Coding Specialists and external vendors that submit risk adjustment data based on medical record reviews. The Medical Coding Auditor is responsible for auditing and training internal Medical Coding Specialists to improve documentation of patient care and to appropriately assign codes.

Essential Duties and responsibilities

• Subject Matter Expert (SME) in the Risk Adjustment Data Validation (RADV) auditing process, all internal and/or regulatory external audits
• Performs quality assurance audits and monitors in accordance to Medicare, Medicaid or other applicable payor standards (i.e. ensure appropriateness and accuracy of ICD-10 coding, CPT, Labs, Diagnostics, etc)
• Provide QA results to the Medical Coding Specialist with recommendations on improvements
• Provide training to internal staff regarding QA results, policies and procedures and best practices
• Responsible for conducting all activities in relation to internal audits, regulatory audits medical record review, identifying best medical record, submitting all necessary paperwork, transmitting data to CMS, responding to all inquiries, and providing expertise and support during the appeals process;
• Works on additional risk adjustment audit requests Serves on the internal Coding Committee as subject matter experts
• Keep abreast of local and national coverage determinations
• Educate assigned ongoing education of ICD-10-CM to the providers
• Perform provider queries and addendum requests based on coding and documentation guidelines to include but not limited to CMA, AMA, AAPC and AHIMA Other duties as assigned

REQUIRED Knowledge, Skills and Experience

• High School Diploma
• Active Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC)
• Must maintain a valid driver’s license and good driving record
• 3 or more years of experience with CPT and HCPC’s with at least 2 or more years’ experience with ICD-10, HCC Coding
• Knowledge of regulatory coding requirements and audits
• Experience with Microsoft Office (Word, PowerPoint, Excel, Outlook)
• Ability to effectively communicate and work with providers and staff
• Excellent written and verbal communication skills and strong interpersonal skills
• Ability to work independently with minimal supervision
• Self-audit of work and awareness of coding impact on revenue cycle
• Ability to meet/or exceed performance metrics
• Ability to travel up to 25% of time as needed

Preferred Knowledge, Skills and Experience

• Associates or Bachelor’s Degree
• Certified Risk Adjustment Coder Certification
• Minimum of 3 year of experience with evaluation and management coding
• Minimum of 3 year of experience with Radiology Coding
• Minimum of 3 year of experience with Lab Coding
• Minimum of 1 year of experience with Aprima, RCx and/or Centricity

Won’t you join us? We are seeking candidates who desire the opportunity and experience of delivering quality and compassionate healthcare - within proven care models – to elderly individuals and those with complex medical issues, who are the forefront of everything we do.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible schedule
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Education:

• High school or equivalent (Required)

Experience:

• ICD-10 CM, CPT and HCPC’s: 1 year (Required)
• Risk Adjustment: 2 years (Preferred)
• production based: 2 years (Preferred)
• E&M Coding: 1 year (Preferred)

License/Certification:

• Certified Professional Coder (CPC) (Required)
• Certified Risk Adjustment Coder (CRC) (Required)

Work Location: Remote

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