Coding Auditor

Join Newport Healthcare: Transform Lives Through Meaningful Work!

Are you ready to embark on a rewarding career in psychiatric healthcare? At Newport Healthcare, we are passionate about delivering exceptional mental health services to individuals in need. Our comprehensive approach covers the entire spectrum of care, creating a wealth of diverse roles for those who aspire to make a real impact. We believe in nurturing talent and fostering professional growth in a supportive environment. Here, you won't just find a job-you'll discover a fulfilling career path in the mental health field.

If you're eager to contribute to a mission-driven organization and help change lives for the better, we invite you to join our dedicated team at Newport Healthcare. Together, we can make a profound difference in the lives of those we serve!

Position Summary:

The coding auditor reviews and audits medical coding for accuracy, compliance, and adherence to healthcare regulations, providing feedback, training, and process improvement recommendations. Ensures medical coding is accurate, compliant with federal regulations, insurance guidelines, and organizational policies. Supports proper billing and reimbursement processes. Examines medical records, billing data, and coding documentation to identify errors and discrepancies.

Key Performance Responsibilities:

• Conduct regular and random audits of coded medical records to ensure accuracy and compliance with ICD-10, CPT, and HCPCS coding standards.
• Review medical documents to validate diagnoses, procedures and treatment codes.
• Identify and correct coding errors and discrepancies, implementing corrective action plans as needed.
• Prepare detailed audit reports and present findings to management or compliance.
• Collaborate with coding, clinical and billing staff to provide feedback, education and training.
• Monitor coding trends, track location and departmental coding patterns, and recommend process improvements.
• Stay current with changes in coding standards, healthcare regulations and payer guidelines.
• Assist in developing, updating and maintaining coding policies and procedures.
• Support compliance initiatives, risk assessment and claim dispute resolution.
• Perform other duties as assigned.

Knowledge, Skills, and Abilities:

• Demonstrates professional behavior reflective of Newport Healthcare's Mission Statement, Philosophy and Values.
• Customer Focus. Actively demonstrates a dedication to meeting the expectations and requirements from internal and external customers; gets firsthand information and uses it for improvements in products and services; always acts with the customer or patient in mind.
• Demonstrates ability to clearly and succinctly communicate both verbally and in writing; can get messages across that have the desired effect.
• Computer Skills. The ability to access systems and to accurately enter and save data. Typical systems might include: Word, Outlook (email and calendaring), HRIS, EMR, and online learning.
• Decision Quality. Must be able to make good decisions based upon a mixture of analysis, wisdom, experience and judgment.
• Must be able to accurately produce work which requires continual attention to detail.
• Functional Skills. Must have the functional and technical knowledge and skills to do the job at a high level of accomplishment.
• Ability to exercise good judgment and apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
• Must be able to orchestrate multiple activities at once to accomplish a goal; uses resources effectively and efficiently.

• Certification as a Certified Professional Coder (CPC) or equivalent (RHIT, RHIA, CCS, APC).
• Minimum of 3 years of medical coding experience, including inpatient and outpatient coding.
• Strong knowledge of ICD, CPT, HCPCS coding systems and healthcare regulations.
• Experience with electronic health records and practice management systems as well as clearinghouses.
• Behavioral health claim experience preferred.
• Strong communication skills for providing training, feedback and collaboration with staff and clinicians.

Hours: 8AM-5PM CST

100% remote

PrairieCare Healthcare is an Equal Opportunity Employer.

PrairieCare provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, genetic information, or any other characteristic protected by federal, state, or local laws.

PrairieCare is committed to ensuring equal employment opportunity, including providing reasonable accommodations to individuals with disabilities. Applicants with a physical or mental disability who require a reasonable accommodation for any part of the application or hiring process are encouraged to email careers@newporthealthcare.com for assistance.