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Atlantic Health · 9 hours ago

Coding and Compliance Internal Auditor I - CPC

Morristown, NJ

Full-time

Onsite

New Grad, Entry Level

0+ years exp

Atlantic Health is a leading non-profit health care system in the nation. The Coding and Compliance Internal Auditor I is responsible for conducting coding quality audits, ensuring accurate code assignments, and providing educational support to healthcare providers.

FitnessHealth CareHospitalMedical

Responsibilities

Coordinates, schedules, performs the professional services documentation and coding audits of outpatient, inpatient, procedures and testing records for physician practices

Evaluates the quality of clinical documentation to identify incomplete or inconsistent documentation that could impact the quality of data being reported

Audits codes and professional fee services performed by providers from medical records according to ICD-10, CPT, HCPCS, and CMS guidelines

Responsible for maintaining up to date knowledge of coding guidelines as they relate to professional services

Develop and coordinate educational and training programs regarding elements of coding such as appropriate documentation, accurate coding, coding trends found during chart reviews, third party audit findings, and annual coding updates

Evaluates and provides appropriate documentation for the third party payer CPT denials to maintain the original CPT assignment, and when necessary, implement corrective action plan and/or educational programs to prevent similar denials and rejections from recurring

Meets with the providers to review the audit findings and to recommend ways to improve when indicated

Orients and trains new providers throughout the year

Audit charts for accurate and correct coding and compliance within documentation guidelines and AHS policies

Prepares written reports of the audit findings by provider/practice

Follows up with providers as needed until documentation improves

Assists with claim denial reports to ensure optimal reimbursement

Serves as a resource to the office staff, providers, and billing department

Provides clarification on coding and compliance policies

Qualification

CPC CertificationICD-10 CodingCPT CodingHCPCS CodingMedical TerminologyCoding AuditsHealthcare ExperienceDocumentation EvaluationTrainingEducationCommunication Skills

Required

CPC Certification

Minimum 6 months experience in similar role highly preferred

High School Diploma, College a plus

Work Experience in the business of healthcare which includes: Medical Terminology and Coding and billing experience

Benefits

Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)

Life & AD&D Insurance.

Short-Term and Long-Term Disability (with options to supplement)

403(b) Retirement Plan: Employer match, additional non-elective contribution

PTO & Paid Sick Leave

Tuition Assistance, Advancement & Academic Advising

Parental, Adoption, Surrogacy Leave

Backup and On-Site Childcare

Well-Being Rewards

Employee Assistance Program (EAP)

Fertility Benefits, Healthy Pregnancy Program

Flexible Spending & Commuter Accounts

Pet, Home & Auto, Identity Theft and Legal Insurance

Company

Atlantic Health

Glassdoor4.0

Atlantic Health is at the forefront of medicine, setting standards for quality health care in New Jersey, Pennsylvania and the New York metropolitan area.

Founded in 1996

Newton, New Jersey, USA

10001+ employees