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Medical Auditor/HCC Analyst - REMOTE Job in Chardon, Ohio

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Job Title: Medical Auditor/HCC Analyst - REMOTE

Employer:Coding Advantage, LLC
Job Location:Remote
Skills:Auditing,Compliance and HCC audits
Specialties:Behavioral Health and Internal Medicine/Family Practice/other
Required Certifications:CPC
Preferred Certifications:CPMA,CRC
Required Experience:5 to 7 years
Preferred Experience:5 to 7 years
Location:PO Box 691 Chardon 44024, OH, US
* Note: This listing is for a remote position
Date Posted:7/26/2021

Medical Auditor/HCC Specialist -Quality Control Analyst

Summary of Position:

Auditing medical charts and records for compliance with industry standard coding guidelines, federal regulations, and various third-party carrier guidelines. Uses knowledge and experience to quality check as a second level other coding and auditing contractors, ensuring that all contractors conform to policies and procedures in place for Coding Advantage, LLC.

Reviews, develops, and/or modifies our internal procedures, systems, and protocols to achieve and maintain quality and consistency throughout our auditing and coding engagements. This position will also provide guidance to other auditing contractors and will enforce our internal auditing and coding compliance standards.

Duties and Responsibilities:

  • Audits medical record documentation to identify deficiencies in documentation in direct relationship to codes billed to carriers. Prepares reports of findings and clearly communicates the appropriate action plans to correct identified deficiencies.
  • Provides second-level review of other auditing contractors to ensure compliance with legal and procedural policies and to ensure optimal workmanship is delivered for our clients.
  • Upon request, researches, analyzes, and responds to our client’s inquiries regarding compliance, coding, denials, and billable services.
  • Trains, instructs, and/or provides technical support to auditing and coding contractors as appropriate regarding coding compliance, documentation, regulatory provisions, and third- party payer requirements.
  • Reviews, develops, modifies, and/or adapts relevant procedures, protocols, and data management systems to maintain consistency to the way we deliver reports to our clients.
  • Ensures strict confidentiality of all clients and/or proprietary company information. A non-disclosure must be signed.
  • Attends coding conferences, workshops to receive updated coding information and changes in coding and/or auditing regulations.
  • Performs miscellaneous auditing and coding client-related duties as assigned.

Minimum Job Requirements

  • Certified Professional Coder (CPC) and at least 3 years of experience directly related to the duties and responsibilities specified.
  • Certified Professional Medical Auditor (CPMA) and/or Certified Professional Compliance Officer (CPCO) designation preferred.


Knowledge, Skills and Abilities Required

  • Knowledge of auditing concepts and principles.
  • Advanced knowledge of medical coding and billing systems and regulatory requirements.
  • Ability to use independent judgment and to manage and impart confidential information.
  • Ability to analyze and solve problems.
  • Strong communication and interpersonal skills. You must be able to be available for Zoom meetings to discuss results with providers.
  • Knowledge of legal, regulatory, and policy compliance issues related to medical coding and auditing.
  • Knowledge of current and developing issues and trends in medical coding.
  • Strong written and verbal communication skills
  • Understanding of Excel and Adobe
  • Detailed knowledge of medical coding systems, procedures, and documentation requirements.
  • Ability to adapt and modify procedures, protocol, and data management systems to meet specific client needs.
  • Ability to provide guidance and training to professional and technical staff in area of expertise.
  • Must be a self-starter, able to work independently “behind the scenes” and provide best practice approach to serving clients.


Send Resume to: Sonda Kunzi


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Subject line must state: Auditor/HCC/QA

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