Coding Auditor - Remote

Overview

The Professional and Ancillary Audit Department at BCBST is seeking a dedicated Coding Auditor to ensure accuracy and compliance in clinical coding, performing thorough claims payment quality and clinical coding compliance audits.

In Short

• Perform audits on clinical coding and claims payment quality.
• Identify opportunities for improvement in processes.
• Communicate audit results and recommend corrective actions.
• Review claims materials and assess accuracy.
• Plan and conduct investigations for certain claims.
• Document audit results and support policy development.
• Work independently and as part of a team.
• Handle confidential and sensitive information.
• Maintain proficiency in coding methodologies and billing requirements.
• Adhere to company policies and guidelines.

Requirements

• Bachelor's degree or equivalent work experience.
• At least 2 years of coding and auditing experience.
• Current AHIMA or AAPC coding certification (CPC or CCS).
• Proficiency in Microsoft Office applications.
• Strong communication and organizational skills.
• Ability to manage multiple assignments and deadlines.
• Solid knowledge of reimbursement methodologies.
• Problem-solving and decision-making skills.
• Positive attitude and self-driven.
• Willingness to comply with tobacco-free hiring practices.

Benefits

• Opportunity to make a difference in healthcare quality.
• Remote-first work environment.
• Comprehensive employee benefits.
• Supportive team culture.
• Professional development opportunities.