You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a Coding Auditor responsible for conducting retrospective audits to ensure compliance with internal policies, CMS regulations, and professional standards. This role involves reviewing billing documentation, managing audit timelines, and effectively communicating findings to management.

Key Responsibilities

• Conduct retrospective audits to ensure compliance with internal policies, CMS regulations, OIG guidance, and state Medicaid plans.
• Review charge information, claim forms, insurance correspondence, and related documentation for accurate billing, coding, claim follow-up, and credit posting.
• Develop and manage audit timelines and schedules.
• Communicate audit findings and recommendations effectively to management and relevant departments.
• Educate physicians, leaders, and staff on documentation deficiencies or coding errors.
• Coordinate with the Manager and Corporate Compliance Department on compliance investigations involving physician groups.
• Participate in compliance investigations as needed.
• Attend internal and external education programs/conferences to support professional development.
• Encourage membership in professional organizations such as AAPC or AHIMA.

Qualifications

• High School Diploma or GED.
• CPC or CCS-P certification required.
• Minimum 3 years of coding and auditing experience required.
• Must have PB Audit Experience.
• 5 years experience in a hospital or clinical setting.

Experience

• Minimum 3 years coding and auditing experience.
• Experience in PB Audit and within a hospital or clinical setting.

Skills

• Strong analytical, problem-solving, and organizational skills.
• Excellent interpersonal and verbal/written communication skills.
• Ability to interact professionally with all levels of the healthcare team.
• Proficiency with Microsoft Office Suite (Excel, PowerPoint, Word).
• Ability to handle difficult situations and individuals objectively.

Additional Requirements

• This is a REMOTE role but requires on-site presence for initial training.
• Training during standard business hours: 8:00 am - 4:30 pm.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.