Senior Medical Coding Auditor
1 week ago
Job Summary
ExL is seeking a skilled Medical Coding Auditor to join our team. As a Medical Coding Auditor, you will perform reviews, analyzes, and codes documentation from medical records to determine payments. This role requires highly technical and specialized functions, with a primary focus on performing thorough reviews of patient encounters to assess completeness and accuracy of provider documentation and CPT and HCPCS coding.
Responsibilities:
- Perform analysis of data and understand reasons for denial reasons, using appropriate codes to document reasons for denials.
- Identify compliance risks and financial opportunities based on chart reviews.
- Prepare reports and executive summaries as required by management regarding audit results, process improvement recommendations, and systemic billing errors.
- Communicate and work with all internal and external customers.
Requirements:
- Life science Bachelor's degree.
- Minimum 5 to 8 years of Coding experience in multispecialty surgery.
- Demonstrated knowledge in CMS Medicare and Medicaid guidelines.
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