Medical Record Auditor

With a 16-year tradition of excellence. A single source provider of world-class technology products and services for the healthcare industry. We are at the forefront of delivering cutting-edge, scalable technologies and solutions that respond to and anticipate the market's needs while providing sustainable value to our customers. Healthcare is our only business, giving us an unparalleled understanding of the volatile healthcare landscape. We take great pride in maintaining the highest levels of client satisfaction for the hundreds of U.S. hospitals and healthcare providers we serve. Our innovative products and services empower our customers to do what they do best – deliver outstanding patient care. Associate would be in charge of conducting Medical Records reviews to identify HCCs (short-term insurance) that still haven't been submitted to CMS (tools provided by the department). Collect the medical records that support those findings upload in to our tool and code it. Evaluates and audits physician and hospital medical records and medical assessment forms to ensure compliance with CMS guidelines and medical documentation requirements. Responsible for serving as final auditing arbiter regarding the Sr. Risk & Recovery’s Retrospective Risk Adjustment (RA) Coding Team and responsible for the identification of training opportunities for our internal and external stakeholders related to CMS guidelines, HCC best practices and medical record documentation requirements.  Essential Functions: - Collects and analyzes data to formulate recommendations and solutions based on audit trends and results. - Provides regular feedback to Sr. Risk & Recovery leadership on performance improvement opportunities as a result of performance gaps. - Acts as a subject matter expert to internal and external stakeholders in the area of CMS requirements and HCC best practices. - Participates in and represents the department in business leadership groups, including external professional groups specializing in coding and provider education. - Assists the business with research and documentation of workflows and policies and procedures.   - Must have Bachelor’s Degree in Health Sciences, Health Management, Nursing; or any combination of EDU/experience - CPC or CPMA (Medical Auditing Certification) from accredited source (American Health Information Management Association, American Academy of Professional Coders, or Practice Management Institute) - At least 5 years of experience relevant to ICD-9 coding or medical record audit experience in a consultative role - Experience developing educational materials and delivering trainings related to ICD-9 coding Advantages of this Opportunity: Competitive salary, negotiable based on relevant experience Benefits offered, Medical, Dental, and Vision Fun and positive work environment Monday through Friday 8am-5pm