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PROFESSIONAL CODING AUDITOR Job in Mountain View, California

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Employer:El Camino Hospital
Skills:Auditing and claim denial reviews,training background,coding
Required Certifications:CPC
Preferred Certifications:CCS
Required Experience:3 to 4 years
Location: Mountain View 94040, CA, US
Date Posted:7/11/2019


(Req #70882)

El Camino Hospital, a non-profit organization with hospital campuses in Mountain View and Los Gatos, California, has been serving communities in the south San Francisco Bay Area for nearly 50 years. We have maintained our preferred workplace status by blending cutting-edge technology with high-quality patient care. We are currently seeking a full-time Professional Coding Auditor to join our team.

The Professional Coding Auditor conducts complex audits for clinic-based providers to ensure selected coded data, Evaluation and Management, and charge assignments are compliant with Official Coding Guidelines in ICD-10-CM coding conventions and CPT/HCPCS coding conventions. The role of the auditor is to educate physicians to ensure that data within the legal medical record is coded efficiently and accurately for appropriate reimbursement and medical necessity to meet regulatory accreditation requirements for state and federal reporting.  The successful candidate will act as liaison and work in conjunction with Patient Financial and Revenue Cycle teams to ensure coded data meets the national standards through collaborative discussion and with direct physician education; provide physician specific education based on the quality monitoring of claim denials and trends; reconcile hospital-based admissions for surgical charge-entry with appropriate CPT and modifier assignments in conjunction of global days in mitigating claim denials and unbundle reporting; participate  in clinic-based onsite training and meetings at various clinic locations; and provide general coding coverage and other duties when necessary.


·         Certified Professional Coder (CPC) 

·         AHIMA Certified Coding Specialist (CCS) credential preferred

·         College-level coursework in ICD-10-CM and CPT coding, anatomy and physiology, and medical terminology

·         Minimum of 3 years of experience in auditing and claim denial reviews in an acute clinic and hospital setting 

·         Strong training background in outpatient clinic setting with direct 1:1 physician education preferred  

·         Minimum 5 years of experience in coding and demonstrated knowledge in the principals and practices of ICD-10-CM and CPT conventions with clinic visits and hospital surgical coding

·         Strong written/verbal communication and organizational skills

·         Proficiency with Excel, Word and Outlook

·         Demonstrated ability to work productively, accurately and independently

·         Proven analytical and problem-solving skills in compiling statistical data and state reporting  

·         Comprehensive mastery of APC assignment methodology with emphasis in NCCI edits

·         Ability to interact well with all levels of employees and physicians throughout the organization; participate in intra- and inter-departmental collaboration; and handle multiple tasks concurrently to meet deadlines

·         Technical aptitude for resolving basic PC hardware and software application problems and ability to perform basic troubleshooting


We truly value our employees, and we’ve developed a benefits package that reflects our gratitude. Some of our employee benefits include:


  • Excellent medical, dental and vision plans
  • Flexible spending accounts and transit benefit
  • Employee assistance plan
  • 403(b) retirement plan with matching contribution (4 percent match)
  • Retirement pension plan (5 percent of salary)
  • Substantial tuition assistance
  • Free, convenient parking
  • Comprehensive employee education department
  • Generous paid time off


If you're looking for an enriching and professionally supportive environment, please apply online at http://www.elcaminohospital.org and refer to requisition #­­­­­­­­­70882. Equal Opportunity Employer







If you're looking for an enriching and professionally supportive environment, please apply online at http://www.elcaminohospital.org and refer to requisition #­­­­­­­­­70882

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