<p>Summary</p> <p>Perform periodic and ongoing audits of claims to ensure accuracy of coding and billing, and sufficiency of supporting documentation.</p> <ul> <li>Audit specified number of records per coder as defined in the system coding audit plan. </li><li>Prepare audit reports that are issued to key stakeholders, as appropriate. </li><li>Develop corrective action plans to address opportunities for coding, billing and documentation improvement. </li><li>Identify trends and educational opportunities. Prepare and present educational programs related to coding. </li><li>Assist in the management of the coding and billing auditing and monitoring program to address high risk compliance areas. </li></ul> <p>Licensure / Certification / Registration:</p> <ul> <li>Certified Coding Specialist (CCS) credentialed from the American Health Information Management Association (AHIMA) preferred. </li><li>Reg Health Info Admnstr credentialed from the American Health Information Management Association (AHIMA) preferred. </li><li>Reg Health Info Tech credentialed from the American Health Information Management Association (AHIMA) preferred. </li><li>Certified Professional Coder (CPC) credentialed from the American Academy of Professional Coders (AAPC) preferred. </li></ul> <p>Education:</p> <ul> <li>High School diploma equivalency OR 1 year of applicable cumulative job specific experience required. </li><li>Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable. </li></ul> <p>Additional Information</p> <p>CPC certification is required, CRC certification is preferred; strong background in ICD-10 coding and HCC knowledge is also preferred.</p>