Job Description

WHO WE ARE

At Skin and Cancer Institute, we believe in more than just jobs; we believe in fostering careers that resonate with excellence, compassion, and innovation. 

Discover a workplace that facilitates growth, celebrates collaboration, and propels your professional journey forward.

Skin and Cancer Institute’s commitment to excellence isn’t just skin-deep – it permeates every aspect of our work. We understand that true impact requires a passion that goes beyond the surface. Here, we believe in nurturing a genuine devotion to dermatology, where every team member is driven by a shared enthusiasm for improving lives through advanced skincare solutions.

Our patients deserve the very best, and it starts with your desire to be of service to others. Your deep-rooted commitment ensures that each individual receives personalized, empathetic care beyond medical treatment.

The Medical Coding Auditor is responsible for reviewing medical records to ensure accurate coding and compliance with regulatory requirements. This role ensures continuous quality improvement in coding practices while maintaining compliance with healthcare laws and organizational policies. The Medical Coding Auditor partners with practices, providers, and other departmental leaders to provide education regarding medical coding and documentation as required by current CMS regulations. The Medical Coding Auditor works directly with the Director of Revenue Cycle Management to implement best practices to maximize revenue, all with a focus on process, communication, and team effort.

ESSENTIAL DUTIES

• Conduct reviews and audits of medical records for coding accuracy (ICD-10-CM, CPT, HCPCS) and documentation compliance.
• Ensure compliance with federal, state, and payer-specific regulations, including CMS guidelines.
• Identify and address coding discrepancies and recommend corrective actions.
• Prepare detailed audit reports with findings and provide feedback on documentation and coding practices.
• Collaborate with relevant departments to resolve audit findings and ensure ongoing compliance with policies and regulations.
• Stay current with changes in coding guidelines, healthcare regulations, and payer policies.
• Assist in developing and refining audit tools, policies, and procedures to support continuous improvement.
• Monitor and track corrective actions post-audit and ensure follow-up to resolve identified issues.
• Ensure abstracted data impacting reimbursement at ASC locations is accurate: discharge disposition, admission source, POA (present on admission) indicators, procedure dates of service, etc.
• Adhere to physician and facility coding guidelines and coding policy and procedures, as needed.
• Leads coding/charge posting team huddles, projects, and communicates KPI requirements as determined through Director of Revenue Cycle Management.
• Participates in the development of coding and billing strategies, evaluating processes related to Revenue Cycle and making recommendations while ensuring compliance with any relevant rules or regulations (including HIPAA, Medicaid, Medicare, and specific 3 rd Party Payors).
• Collaborates with EDI team to ensure claims data is transferring through the clearinghouse appropriately.
• Maintains professional relationships and collaborates across teams, managing projects, facilitating meetings and presenting in various settings, including senior leadership.
• Prepares and coordinates revenue cycle responsibilities within the acquisition/implementation process. This includes but is not limited to staff onboarding, vendor management, and clearinghouse management.

SKILLS/QUALIFICATIONS/EXPERIENCE

• 3-5 years of relevant experience in physician or facility medical coding, auditing, or compliance roles.
• At least 3 years of experience in a Coding lead role.
• 2+ years of experience in a remote working environment.
• Bachelor’s degree in related field preferred but not required.
• Must have a high school diploma or equivalent certificate.
• Certifications required: CPC, COC, and CPMA.
• Demonstrate an understanding of healthcare management, including staffing and leadership.
• Demonstrate an understanding of patient accounts.
• Ability to educate patients on explanation of benefits for insurance processed claims.
• Communicate effectively with healthcare workers, patients and insurance companies.
• Able to prioritize and organize daily tasks.
• Strong attention to detail, positive attitude and a proven ability to lead a team to success.
• Proficient in Microsoft Word, Outlook and Excel.
• Knowledge of state regulations.
• Presentation skills are desirable.
• Must have excellent written and verbal communication skills.
• Able to work with a diverse group of people.
• Must be able to work in a fast-paced office environment.

EQUIPMENT & SOFTWARE OPERATION

The incumbent in this position may operate any/all of the following equipment:

Microsoft Outlook, Word, Excel, PowerPoint, fax, email, phone, NextGen, EMA

POSITION REQUIREMENTS

• Associate degree highly preferred.
• 5+ years of related experience required.
• Proficiency in Microsoft Office with advanced Excel skills.
• Experience with Intacct, ConnectWise, Ubersmith, System Integration and M&A a plus.
• Strong communication skills, written and verbal.
• Ability to work independently and manage time appropriately.

Job Tags

Similar Jobs