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Coding Auditor

Location: Pembroke Pines, FL
Job Family: Medical
Req #: PS48178
Date Posted: Apr 7, 2021

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company.

Coding Auditor 

*Due to Covid-19 the position is currently remote until plans to return to the office can be determined.* 

The Coding Auditor is responsible for auditing diagnosis data collected from physician and hospital medical records to ensure proper ICD 10 coding and compliance with risk adjustment requirements.

Primary duties may include, but are not limited to:

  • Collects and analyzes data to formulate recommendations and solutions based on audit trends and results.
  • Assign proper ICD 10, CPT, HCPCS codes, and Modifiers for all services provided daily.
  • Queries physicians when code assignments are not straightforward or documentation is unclear.
  • Assists physicians and providers with questions and problems related to coding, documentation, and billing.
  • Provides regular feedback to Operations leadership on performance improvement opportunities as a result of performance gaps.
  • Assesses and identifies training opportunities.
  • Maintains current knowledge of requirements and guidance required in the performance of audit duties.
  • Reviews medical records that have been reviewed and coded.

Qualifications

  • Requires a high school diploma or GED.
  • 1 year of experience as a coder of medical records in a physician office, hospital, or insurance/coding office setting; or any combination of education and experience, which would provide an equivalent background.
  • 1 year of experience in Risk Adjustment coding and chart review preferred.
  • Medical Coder certification from an accredited source (e.g. American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute) is required.
  • BS in health sciences, health management, or related field is preferred.
  • Experience with Microsoft Office programs and EHR systems is highly desired.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.  An Equal Opportunity Employer/Disability/Veteran.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.  Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

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