Coding Auditor Resume Samples

A Coding Auditor assumes accountability for auditing diagnosis data that are collected from physicians and hospital medical records and ensures ICD-10 coding and compliance with risk adjustment requirements. A well-drafted Coding Auditor Resume mentions the following core duties and responsibilities – collecting and analyzing data to formulate recommendations and solutions based on audit trends, providing regular feedback to operations leadership, participating in and representing the department in business leadership groups; assessing and identifying training opportunities, maintaining current knowledge of requirements and guidance, and reviewing medical records that are coded and reviewed.

Qualifications needed to succeed in this career include – experience as a coder of medical records in a coding or insurance office setting; knowledge of medical terminologies, the ability to use appropriate software, and certified risk adjustment coder credentials. A high school diploma is commonly considered a minimum requirement.

Coding Auditor Resume example

Coding Auditor Resume

Objective : Looking to obtain a position that will allow individual growth in a leadership role, while maintaining efficient and effective work habits in a challenging work environment.

Skills : Inpatient Coding, OP Coding, Speciality Coding.

Description :

    1. Conducted audits for a multi-specialty group of over 50 providers on evaluation and management for clinic, hospital, home health, and nursing home services provided, as well surgical procedures.
    2. Performed focused audits on providers that are not compliant with CMS documentation guidelines.
    3. Provided individualized audit results and education.
    4. Reviewed ADR and Cert Request.
    5. Provided Shadowing in Clinic for documentation improvement.
    6. Performed charge master audits using the OIG work plan as a guide.
    7. Worked closely with the compliance department to ensure that all providers are compliant with CMS, OIG, and other federal regulations.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
Business And Management


Coding Auditor Resume

Objective : Seeks to achieve a position as a Medical Coder and/or related to the profession that would allow utilizing certification, experience, education, and knowledge that have acquired.

Skills : Completed ICD 10 Training Through AAPC. Extensive Knowledge.

Description :

    1. Performed coding compliance audits of patient care billing documentation in accordance with Facey Medical Foundation's annual Compliance Work Plan, and prepare written and oral communication to the Coding Compliance Lead and Coding Compliance Coordinator on the results of audits performed.
    2. Analyzed medical charts for completeness and codes diseases and operations for abstracts.
    3. Audited records to ensure proper submission of services prior to billing on pre-determined selected charges.
    4. Received hospital information to properly bill provider services for hospital patients.
    5. Attended seminars and in-services as required to remain current on coding issues.
    6. Provided coding training and communications to providers and third-party billing.
    7. Notified medical staff of uniform billing practices, documentation problems, and coding strategies for maximum reimbursement.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
CCS Exam Prep


Coding Auditor Resume

Headline : Seeks to pursue an opportunity that allows using diverse expertise in the medical coding and billing field. To demonstrate strong work ethics combined with a commitment to excellence in job performance.

Skills : Knowledge Of Word, Excel, PowerPoint, EncoderPro, Eclinical Works, Ic-Chart, IDX, Claims Manager, And Reports, And Cerner PowerChart.

Description :

    1. Responsible for assigning appropriate CPT, HCPCS, and diagnosis codes to claims for multi-specialty providers.
    2. Responsible for posting charges to the billing system.
    3. Assisted Claims Specialists in the prebill process to ensure accuracy of billed services prior to bill submission.
    4. Researched, assisted, and followed up on claim denials.
    5. Participated and performed monthly audits for Genesis Health System providers.
    6. Assisted office staff/providers with coding, billing, and documentation-related issues.
    7. Accurately and efficiently conducted medical record reviews for HEDIS HCC and RXHCC measures.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Certificate In Evaluation & Management

Coding Auditor Resume

Headline : Looking to acquire a position that will enable utilizing knowledge, education, and experience. Combining strong interpersonal and communication skills, and committed to continual performance development in the workplace. A challenging and rewarding position as a Remote Coder.

Skills : Auditing Skills, Consultant Skills.

Description :

    1. Audited physician charts to comply with correct coding and documentation.
    2. Coded Peripheral Vascular charts, emergency room charts, and NICU charts.
    3. Consulted all departments on correct coding and documentation to be compliant.
    4. Trained of the Cath Lab, Radiology, MRI, CT Scan, and pathology on coding and documentation.
    5. Ensured that all quotas and assignments are completed in a timely fashion.
    6. Edited and Re-coded as appropriate.
    7. Provided assistance for technical coding navigation through AHLTA.
      Years of Experience
      Experience
      5-7 Years
      Experience Level
      Level
      Executive
      Education
      Education
      Advanced Coding And HRM

      Coding Auditor Resume

      Summary : Seeks to acquire a position that will enable utilizing knowledge, education, and experience. Combining strong interpersonal and communication skills, and committed to continual performance development in the workplace.

      Skills : Microsoft Word, Excel, Access, And PowerPoint All Versions Ingenix Encoder, Pro Tenet Cerner, Pdoc Systems, Mckesson, Meditech, Medhost 3M, Proficiency Data Entry.

      Description :

        1. Protected against fraudulent claims and billing activity. 
        2. Helped identify and correct problem areas before insurance or government payers challenge.
        3. Audited HCC coding claims for accuracy and completeness.
        4. Coded ER charts for professional and facility assigning E/M, diagnostic, procedural, injections.
        5. Audited all medical claims prior to submission for reimbursement, query physicians for missing information, process payments from self-pay patients.
        6. Processed within timely filing, AR was 28 days out.
        7. Audited medical coder's work to ensure all HCCs are abstracted from the charts.
        Years of Experience
        Experience
        7-10 Years
        Experience Level
        Level
        Management
        Education
        Education
        Medical Billing

        Coding Auditor Resume

        Summary : Currently seeking a position in Coding Auditor. Further, seeking employment with a company that will utilize experience and skills in HCC coding (Hierarchical Condition Categories).

        Skills : Microsoft Office, Data Management.

        Description :

          1. Directed reviews and audits of outpatient services held for claims resolution and research.
          2. Abstracted surgical codes for multiple specialties, as well as supported physicians with coding questions.
          3. Provided one-on-one coaching and education in coding for clinical staff.
          4. Processed medical records for In-Patient Coding in compliance with local, state, and Federal guidelines.
          5. Researched and reviewed Medicaid guidelines and rules for each state in which an audit was performed.
          6. Utilized data in Excel spreadsheets.
          7. Performed concurrent ICD-10-CM/PCS and CPT coding analysis of medical records to validate code assignment.
                Years of Experience
                Experience
                7-10 Years
                Experience Level
                Level
                Management
                Education
                Education
                HS

                Coding Auditor Resume

                Summary : Seeking a challenging position in a healthcare environment that would enable using experience, training, education, and ability in making a positive contribution to the healthcare industry.

                Skills : ICD-9, ICD-10, CPC.

                Description :

                  1. Reviewed multi-specialty encounters in all settings for all lines of business to ensure accurate ICD-9-CM.
                  2. Audited physician journals for compliance within the deadline.
                  3. Query physicians to correct deficiencies in documentation.
                  4. Multispecialty outpatient coding.
                  5. Corrected back-end errors and resolving edits.
                  6. Worked closely with the clinic coders and clinic managers to ensure consistency with documentation.
                  7. Assisted with denials, reviewing documentation for appeal.
                  Years of Experience
                  Experience
                  7-10 Years
                  Experience Level
                  Level
                  Management
                  Education
                  Education
                  HS

                  Coding Auditor Resume

                  Summary : Seasoned professional looking to grow and succeed in a dynamic environment. A proven track record of exceeding departmental goals while initiating operational enhancements to improve quality and reduce costs.

                  Skills : PowerPoint all Versions, Ingenix, Encoder Pro, Tenet Cerner. Pdoc Systems, Mckesson, Meditech, Medhost 3M, Coderyte Epic PremiEHR PC Proficiency Data Entry.

                  Description :

                    1. Performed new provider orientation, teaching billing, and coding.
                    2. Utilized the documentation guidelines, along with payer-specific information and the CMS internet-only manuals.
                    3. Educated on fraud and abuse using the OIG's Roadmap for New Physicians.
                    4. Identified risks and taking appropriate action.
                    5. Responsible for validating Neoplasm and other ICD-9 codes submitted in outpatient.
                    6. Abstracted HCC codes may not have submitted by physicians.
                    7. Abstracted HCC's from Inpatient/Outpatient records.
                  Years of Experience
                  Experience
                  7-10 Years
                  Experience Level
                  Level
                  Management
                  Education
                  Education
                  Advanced Coding and HRM

                  Coding Auditor Resume

                  Summary : Seeks to obtain a permanent career that provides challenging assignments as well as growth opportunities that will motivate to contribute to the productivity of the company and further develop skills.

                  Skills : Patient Care, MS office.

                  Description :

                    1. Scheduled chart reviews in the Metro.
                    2. Responsible for helping co-workers with any questions and reviewing several of their encounters per week and keeping a spreadsheet of theirs.
                    3. Inpatient reviewed criteria may include: principal and secondary diagnosis code (accuracy, omission, etc.), Diagnosis Related Groups accuracy, correct Present on Admission assignment.
                    4. Contracted shall have a methodology for resolving coding questions by reviewers and ensuring inter-reviewer consistency and reliability.
                    5. Applied Official Guidelines for Coding and Reporting consistently and appropriately.
                    6. Provided written explanations to support or rebut audit recommendations.
                    7. Demonstrated working knowledge of all facets of role, relevant regulations, and organizational and departmental policies and procedures. 
                            Years of Experience
                            Experience
                            7-10 Years
                            Experience Level
                            Level
                            Management
                            Education
                            Education
                            Advanced Coding and HRM

                            Coding Auditor Resume

                            Summary : Looking to utilize skills and strengths, accept challenges, be part of a team that will assist in enhancing the quality of people's lives, and assists in leading an organization to reach its fullest potential.

                            Skills : Implementational Skills, Patient Care.

                            Description :

                              1. Reviewed Patient Account Representative's daily coding journals from several MFI clinics.
                              2. Participated in required training.
                              3. Abstracted diagnosis from inpatient and outpatient charts for Medicare HCC Coding.
                              4. Multitasked and troubleshoot problems independently.
                              5. Encountered/quartered are identified by billed episode and then audited against these three criteria. If the encounter does not have a Common Procedural Terminology procedure code associated with the visit, then that data point is not audited.
                              6. Determined the accuracy and sequencing of the diagnoses coded and identify the reason(s) if not.
                              7. Determined the accuracy of Common Procedural Terminology/Healthcare Common Procedural Coding System codes and modifiers and the reason(s) if not accurate.
                                      Years of Experience
                                      Experience
                                      7-10 Years
                                      Experience Level
                                      Level
                                      Management
                                      Education
                                      Education
                                      Advanced Coding and Human Resource Management