OverviewHarmonyCares is one of the nation's largest home-based primary care practices. HarmonyCares is a family of companies all dedicated to providing high-quality, coordinated health care in the home. This includes HarmonyCares, HarmonyCares Medical Group, HarmonyCares Home Health and HarmonyCares Hospice.
Our Mission - To bring personalized, quality-based healthcare to the home of patients who have difficult accessing care.
Our Shared Vision - Every patient deserves access to quality healthcare.
Our Values - The way we care is our legacy. Every interaction counts. Go the extra mile. Empower and support each other.
Why You Should Want to Work with Us
- Health, Dental, Vision, Disability & Life Insurance, and much more
- 401K Retirement Plan (with company match)
- Tuition, Professional License and Certification Reimbursement
- Paid Time Off, Holidays and Volunteer Time
- Paid Orientation and Training
- Great Place to Work Certified
- Established in 11 states
- Largest home-based primary care practice in the US for over 28 years, making a huge impact in healthcare today.
ResponsibilitiesThe Medical Coding Auditor performs quality assurance audits on Medical Coding Specialists and external vendors codes based on medical record reviews. The Medical Coding Auditor is responsible for providing QA results, feedback, and training to internal Medical Coding Specialist to ensure accurate coding submissions.
Essential Duties and Responsibilities
- Ensure HarmonyCares submission follow all relevant coding guidelines related to ICD-10-CM, CPT, HCPCS, as well as CMS reimbursement policies, including MLNs, NCDs/LCDs, and the Claims Processing Manual
- Perform coding quality assurance audits on outpatient encounters, including E/M, Preventive services, Labs, Diagnostics, and Denials
- Ensure accuracy and completeness of risk adjustment codes for outpatient encounters
- Provide QA results to the Medical Coding Specialist with feedback on errors
- Track individual coder results to recognize coding error trends;
- Holds 1:1 feedback & training sessions with coders below standards
- Respond to coding questions and QA result rebuttals
- Provide training to internal staff regarding QA results, policies, procedures and best practices
- Works on additional risk adjustment audit requests
- Ensure Coding team provider queries satisfy AHIMA compliant query guidelines
- Performs other duties as assigned
QualificationsREQUIRED Knowledge, Skills and Experience
- High School Diploma
- Current Certified Professional Coder (CPC) Certification from the American Academy of Professional Coders (AAPC) or AHIMA Coding Certification
- 3+ years of experience coding in an outpatient environment
- Knowledge of CMS and payer audits
- Experience with Microsoft Office (Word, PowerPoint, Excel, Outlook)
- Ability to effectively communicate and work with providers and staff
- Excellent written and verbal communication skills and strong interpersonal skills
- Ability to work independently with minimal supervision
- Self-audit of work and awareness of coding impact on revenue cycle
- Ability to meet/or exceed performance metrics
Preferred Knowledge, Skills and Experience
- Associates or Bachelor's Degree
- CPMA, CRC certifications
- Experience with coding topics, including risk adjustment (HCC), E/M, denials and audit defense, diagnostic/radiology, and lab coding