Clinical Documentation Integrity Coding Auditor

Summary

Join Honest Health as a Clinical Documentation Integrity Coding Auditor and play a crucial role in ensuring accurate medical coding and documentation. You will conduct comprehensive audits, analyze medical records, collaborate with healthcare providers, and educate staff on coding guidelines. This position requires a high school diploma or equivalent, a preferred degree in a related field, and a relevant coding certification. Experience in coding, Medicare Advantage Risk Adjustment, and CDI is essential. Honest Health offers a competitive compensation package, including a base salary, performance-based bonuses, comprehensive benefits, paid time off, flexible work arrangements, and professional development opportunities.

Requirements

• A high school diploma or equivalent is required
• Must hold a Certified Coding Specialist (CCS), Certified Coding Specialist-Physician-Based (CCS-P), Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), or Certified Risk Coder (CRC) credential
• 3+ years of coding experience and Medicare Advantage Risk Adjustment in outpatient healthcare setting
• Extensive knowledge of medical coding systems and guidelines, including ICD-10-CM, CPT, and HCPCS Level II coding
• Solid understanding of healthcare reimbursement methodologies and regulatory compliance requirements
• Strong analytical and critical thinking skills, with the ability to identify patterns, trends, and areas for improvement
• Excellent communication and interpersonal skills to collaborate effectively with healthcare professionals and coding staff
• Proficient in using electronic health record (EHR) systems, coding software, and other healthcare technology platforms
• Proficient computer skills
• Excellent communication skills, both verbal and written
• Attention to detail and accuracy, with a commitment to maintaining high standards of documentation integrity
• Strong organizational and time management skills to prioritize tasks and meet deadlines

Responsibilities

• Conduct comprehensive audits of clinical documentation and medical coding to ensure compliance with coding guidelines, regulations, and industry standards
• Analyze clinical documentation to identify discrepancies, coding errors, and documentation gaps that may impact coding accuracy, reimbursement, and compliance
• Collaborate with CDI department and healthcare providers to clarify documentation queries, improve documentation quality, and enhance coding specificity
• Provide education and training to physicians, clinicians, and coding staff on proper documentation practices, coding guidelines, and regulatory requirements
• Prepare detailed audit reports that include findings, recommendations, and action plans
• Present audit results to management, coding teams, and other necessary parties highlighting areas of concern and opportunities for improvement
• Communicate coding updates, regulatory changes, and compliance requirements to coding staff and healthcare providers
• Perform other related responsibilities as assigned

Preferred Qualifications

• A degree in health information management (HIM), medical coding, or a related field is preferred
• Prior experience in clinical documentation improvement (CDI) is highly desirable; familiarity with CDI processes, documentation integrity, and clinical documentation improvement programs is preferred
• Experience working with clinical documentation improvement (CDI) programs and familiarity with CDI best practices

Benefits

• Competitive Compensation
• Attractive base salary with performance-based bonuses and rewards
• 401(k) plan with a generous company match, fully vested from day one
• Comprehensive Health and Wellness Benefits
• Flexible health, dental, and vision insurance options tailored to your needs
• Company contribution towards health savings accounts (HSA) for high-deductible health plan (HDHP) participants
• 100% company-paid short-term disability, long-term disability, and life insurance
• Wellness programs and resources to support your physical and mental health
• Generous paid time off, including vacation, sick leave, and 11 paid holidays annually
• Two paid volunteer days to support causes you're passionate about
• Flexible work arrangements to accommodate your lifestyle
• Robust onboarding program and ongoing training opportunities
• Reimbursement for role-related continuing education and certifications
• Paid parental leave for new parents
• Dependent care flexible spending accounts
• Support for work-life integration
• Team member recognition programs
• Team-building events and social activities