Coding Auditor

Position Overview Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi‑specialty physician networks and urgent care clinics that align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continued growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve. Coder Certification Required . The Coding Auditor is responsible for determining that ICD‑10, CPT‑4, and HCPCS coding is supported by the clinical documentation in the medical record as well as validating medical necessity per CMS Local Coverage Determination (LCD). The role applies working knowledge of medical terminology, anatomy, CPT‑4 and ICD‑10 codes and coding skills/experience to ensure timely and accurate audits of clinical documentation as requested. Key Responsibilities Performs accurate and timely review of clinical documentation to ensure that ICD‑10, CPT‑4 and HCPCs coding is supported by the clinical documentation in the medical record. Meets or exceeds established performance targets (productivity and quality) established by the Manager, Coding. Reviews audit samples following CBO IPM policy and utilizing established protocols, audit tools and worksheets to report accurate and timely findings to the Coding Manager. Meets or exceeds established performance targets (productivity and quality) established by the Manager, Coding. Assists in educating providers on clinical documentation requirements to support their coding and ensure all coding (charge) possibilities are being captured. Provides feedback on audit and education plans and materials and makes recommendations for updates that will enhance the auditing process. Maintains an expanded knowledge base of CPT‑4 and ICD‑10 codes, government, managed care and third‑party billing guidelines, AMA, AAP, CMS and coding policies. Meets continued education guidelines to maintain current AAPC CPC certification. Exercises good judgement in escalating identified coding trends that may negatively impact productivity, quality or revenue to enhance clinical documentation to support codes billed, drive consistency across IPM, mitigate claim denials, expedite reprocessing of claims and maximize opportunities to enhance front‑end, coding‑related claim edits to facilitate first‑pass resolution. Participates in regularly scheduled team meetings offering new paths, procedures and approaches to maximize opportunities for performance and process improvement. Qualifications High School Graduate/GED required. Associate Degree preferred. 3‑5 years of experience required working in a healthcare (professional) billing, health insurance, coding, auditing or equivalent operations work environment. Auditing experience required. AAPC CPC Certification required. Knowledge of healthcare (professional) billing, CPT‑4 and ICD‑10 codes, government, managed care and third‑party billing guidelines, AMA, AAP, CMS and coding policies. Understanding of the revenue cycle and how the various components work together preferred. Excellent organizational skills, attention to detail, research and problem‑solving ability. Results oriented with a proven track record of accomplishing tasks within a high‑performing team environment. Service‑oriented/customer‑centric. Strong computer literacy skills including proficiency in Microsoft Office. Billing software (e.g., Cerner, Epic, IDX) experience highly desirable. Benefits Excellent Medical, Dental, Vision and Prescription Drug Plans Competitive Compensation & Generous Paid Time Off 401(k) with company match Tuition Reimbursement and much more! EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates with matching skillset and experience with the best possible career at UHS and our subsidiaries. We take pride in creating a highly efficient and best‑in‑class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you feel suspicious of a job posting or job‑related email, let us know by contacting us at: or View phone number on click.appcast.io. #J-18808-Ljbffr Independence Physician Management (IPM)