Coding Quality AuditorPrimary Location: Cranberry, PA
Additional Locations: PA-Cranberry Apply
66670Fundamental Components: Performs audits of medical records to ensure all assigned ICD-10 codes are accurate and supported by written clinical documentation. Provides education to internal staff and external providers based on audit findings; provides general education on ICD-10 codes as appropriate. Effectively communicates the audit process and results to the appropriate departments and management. Assists senior level staff in providing recommendations for process improvement so that productivity and quality goals can be met or exceeded and operational efficiency and financial accuracy can be achieved. Maintains current knowledge of ICD-10 codes, CMS documentation requirements, and state and federal regulations. Performs other related duties as required. Background Experience: Experience with Microsoft Office products (Word, Excel, Project, PowerPoint, Outlook).Experience with ICD-10 codes required.Experience with Medicare and/or Medicaid Risk Adjustment process requiredCPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) requiredMinimum of 2 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing.Excellent analytical and problem solving skillsEffective communications, organizational, and interpersonal skills. High School Diploma or G.E.D. Additional Job Information: This coding auditor position helps in regulatory audits and other tasks assigned to help the department. Candidate may be asked to work multiple projects or audits. Must be CPC or CCS certified. Experience in risk adjustment preferred. Potential Telework Position: Yes Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
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