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Healthcare Data Auditor

1 week ago


Cebu City, Central Visayas, Philippines Health Business Solutions Full time
Job Summary:

We are looking for a skilled Coding Auditor to join our team at Health Business Solutions. As a Coding Auditor, you will be responsible for reviewing and auditing medical records to ensure accurate coding and compliance with regulatory requirements.

You will work closely with our coding teams, providers, and clinical staff to educate on coding practices and provide feedback on regulatory compliance.

Your expertise in medical coding, including ICD-10, CPT, and HCPCS, will be essential in identifying errors and discrepancies in coding practices and providing recommendations for process improvement.

We are looking for a detail-oriented and organized individual with certifications in medical coding, such as CPC, CCS, or CIC, and experience working with risk adjustment audits, clinical documentation improvement (CDI), and payer audits.

  • Key Responsibilities:
  • Review and Audit Medical Records: Conduct thorough audits of medical records to ensure accurate coding and compliance with regulatory requirements.
  • Ensure Regulatory Compliance: Verify that all medical coding aligns with applicable federal, state, and local laws and regulations.
  • Identify Errors and Gaps: Detect and correct coding discrepancies, missing or incomplete documentation, and over- or under-coding issues.
  • Provide Feedback and Education: Educate coding staff and healthcare providers on accurate coding practices, documentation improvement, and regulatory changes.
  • Prepare Audit Reports: Compile detailed reports highlighting findings and recommendations for process improvement.