Coding HCC Auditor

Day-to-Day Responsibilities : Insight Global is seeking a Coding / HCC (Hierarchical Condition Category) Auditor who is responsible for reviewing medical records and associated documentation to ensure accurate and proper documentation related to coding of ICD-10, HCC, CPT, CPT2 and HCPC codes. The Auditor will identify errors, discrepancies, and areas for improvement in coding, billing, and documentation processes. This role often involves providing education and training to coding staff, providers and contributing to improvement initiatives related to charge capture process. In addition, this position will act as a quality control specialist, ensuring the accuracy and compliance of medical coding practices, particularly within the surgical and related professional services billing realm.

Responsibilities include, but are not limited to :

• Reviewing Medical Records :
• Examining medical charts and documentation to verify the accuracy of CPT, ICD-10, HCC, HCPCS codes, and modifiers assigned to surgical procedures and related professional services.
• Ensuring Compliance :
• Verifying adherence to healthcare regulations, payer-specific guidelines, and industry standards, including and regulations.
• Identifying and Correcting Errors :
• Detecting discrepancies, coding errors, and documentation deficiencies, and collaborating with coding staff to implement corrections and improvements.
• Providing Education and Training :
• Delivering training to coding staff on best practices, coding updates, and compliance requirements, often through workshops, seminars, and individual feedback.
• Reporting and Analysis :
• Preparing detailed audit reports, analyzing trends, and presenting findings to management and relevant stakeholders.
• Policy Development :
• Assisting in the development and maintenance of coding policies, procedures, and guidelines.
• Collaboration :

Working closely with various departments, including billing, compliance, and clinical teams, to ensure seamless coding and billing processes.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity / affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and / or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy :

Required Skills & Experience

Must Haves :

This person will be communicating with physicians and coders and needs to be able to communicate clearly and respectfully

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and / or other paid time off as provided by applicable law.