Clinical Auditor Coding Certification

Job Summary

A company is looking for an Auditor Clinical Validation OPSP Coding.

Key Responsibilities

• Audit outpatient and specialty claims utilizing medical chart coding principles
• Effectively utilize audit tools to ensure accurate claim entry and maintain productivity standards
• Identify new claim types and recommend process improvements based on extensive healthcare auditing experience

Required Qualifications

• Associate or bachelor's degree in Health Information Management (RHIA or RHIT) or equivalent experience
• Coding certification required (e.g., CPC, CIC, CCS, CCS-P, RHIA, or RHIT)
• 5 to 7 years of experience in clinical medical record coding or auditing
• Broad knowledge of medical claims billing/payment systems and coding terminology
• Expert knowledge of coding guidelines and compliance mandates (e.g., DRG, ICD-10, CPT, HCPCS codes)