Talent.com
Coding Auditor
Coding AuditorChildren’s National • Silver Spring, Maryland
Coding Auditor

Coding Auditor

Children’s National • Silver Spring, Maryland
30+ days ago
Job type
  • Full-time
Job description

Coding Auditor-(250002UP)

Description

The Coding Auditor demonstrates expertise in coding and billing compliance while performing audits to determine billing integrity of professional and facility / technical fees including detection and correction of documentation, coding and billing errors and / or medical necessity of services billed. Audits consist of evaluation of the adequacy and accuracy of documentation in support of services billed including ICD-10 / CPT / HCPCS and other third party payor codes, DRG and EAPG assignments, medical necessity of the services, reimbursement overpayments and underpayments, and compliance with other documentation, coding and billing standards. The Coding Auditor applies standardized audit scoring methodology to consistently evaluate documentation and coding, and standardized audit findings methodology to report audit results.

Qualifications

Minimum Education

Associate's Degree Candidates with 3 years of coding experience in lieu of the degree requirement will be considered. .

Minimum Work Experience

2 years as a Certified Coder preferably with experience in pediatric coding and / or experience performing coding audits within an academic medical center (Required)

Required Skills / Knowledge

  • Interpret and apply documentation and coding rules and regulations along with charge capture and reimbursement methodologies;
  • Plan, conduct and perform coding audits;
  • Work cooperatively with Medical Center administrative staff, department staff, and providers;
  • Manage diverse and conflicting priorities and projects effectively and meet deadlines;
  • Maintain competence in and up-to-date knowledge of healthcare billing and coding compliance requirements, practices and trends;
  • Conduct detailed coding audits, reach independent decisions and logical conclusions and prepare report of findings;
  • Interpret medical records progress notes, hand written and electronic chart entries, provider orders, and other related documentation;

Proficiency in the use of personal computers with Windows operating systems including Microsoft applications such as Word, Excel, Outlook, PowerPoint and Access.

Communicate effectively both verbally and in writing.

Required Licenses and Certifications

CCS, CIC, CPC, CPC- H, or COC. (Required)

CPMA and / or CEMA / C or ability to acquire within 6 months after start date. (Required)

Functional Accountabilities

  • Performs scheduled and unscheduled independent audits of professional fee documentation, coding and medical necessity related to professional service providers such as physicians and NPPs (Non-Physician Providers) as well as facility / technical fee billing audits (inpatient and outpatient) as assigned.
  • Conducts specialized and focused audits.
  • Evaluates the appropriateness and medical necessity of services and procedures billed based on supporting documentation.
  • Evaluates the appropriateness of ICD-10, HCPCS and CPT codes, APC / EAPG, DRG, and admission assignments, along with modifier usage.
  • Evaluates accuracy of supply and implant charge capture and coding based on Medical Center policies and related payor requirements.
  • Makes determinations of overpayments and underpayments and performs other related analysis and evaluations.
  • Adheres to the defined audit timeline and audit protocol standards.
  • Assists with development of the audit schedule.
  • Identifies services to be audited.
  • Applies consistent and standardized billing audit methodology for sample selection, scoring and benchmarking development and reporting of findings. Reports findings in standardized format by established deadline so findings can be appropriately communicated.
  • Maintains knowledge of current Medicare, Medicaid and other third party payor billing and documentation requirements.
  • Meets department expectations about daily productivity targets and deadlines
  • Creates educational material for clinical and non-clinical staff.
  • Other duties as assigned
  • Organizational Accountabilities

    Organizational Accountabilities (Staff)

    Organizational Commitment / Identification

  • Anticipate and responds to customer needs; follows up until needs are met
  • Teamwork / Communication

  • Demonstrate collaborative and respectful behavior
  • Partner with all team members to achieve goals
  • Receptive to others’ ideas and opinions
  • Performance Improvement / Problem-solving

  • Contribute to a positive work environment
  • Demonstrate flexibility and willingness to change
  • Identify opportunities to improve clinical and administrative processes
  • Make appropriate decisions, using sound judgment
  • Cost Management / Financial Responsibility

  • Use resources efficiently
  • Search for less costly ways of doing things
  • Safety

  • Speak up when team members appear to exhibit unsafe behavior or performance
  • Continuously validate and verify information needed for decision making or documentation
  • Stop in the face of uncertainty and takes time to resolve the situation
  • Demonstrate accurate, clear and timely verbal and written communication
  • Actively promote safety for patients, families, visitors and co-workers
  • Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance
  • Primary Location

    : Maryland-Silver Spring

    Work Locations

    : Dorchester12200 Plum Orchard DrSilver Spring20904

    Job

    : Non-Clinical Professional

    Organization

    : FinancePosition Status : R (Regular)-FT - Full-TimeShift : DayWork Schedule : 9-530

    Job Posting

    : Dec 10, 2025, 3 : 36 : 40 PM

    Full-Time Salary Range

    : 64188.8-106995.2

    Create a job alert for this search

    Coding Auditor • Silver Spring, Maryland

    Similar jobs
    Board Certified Behavior Analyst / BCBA - Full time

    Board Certified Behavior Analyst / BCBA - Full time

    ICBD • Alexandria, VA, US
    Full-time
    Board Certified Behavior Analyst / BCBA – ABA Centers of Virginia.RELOCATION PACKAGE UP TO $15K • •.STUDENT LOAN FORGIVENESS UP TO $24K • •. We’ve Created the Ideal BCBA Work Culture.Student...Show more
    Last updated: 30+ days ago • Promoted
    Remote Board Certified Behavior Analyst

    Remote Board Certified Behavior Analyst

    BK Behavior • Columbia, MD, US
    Remote
    Full-time +1
    Board Certified Behavior Analysts (BCBAs).Applicants must already hold active BCBA certification.Our training program is designed to support certified BCBAs in excelling within our company.Transiti...Show more
    Last updated: 30+ days ago • Promoted
    Senior Manager Coding Audits & Education

    Senior Manager Coding Audits & Education

    Children's National Hospital • Silver Spring, MD, United States
    Full-time
    Senior Manager Coding Audits & Education.Senior Manager Coding Audits & Education.Be among the first 25 applicants.This range is provided by Children's National Hospital. Your actual pay will be bas...Show more
    Last updated: 30+ days ago • Promoted
    Remote Accounting Expert - AI Trainer ($50-$60 / hour)

    Remote Accounting Expert - AI Trainer ($50-$60 / hour)

    Data Annotation • Alexandria, Virginia
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...Show more
    Last updated: 7 days ago • Promoted
    Senior AML Monitoring Lead - Payments

    Senior AML Monitoring Lead - Payments

    Google • Washington, DC, United States
    Full-time
    A leading technology company is looking for an AML Transaction Monitoring Lead to manage compliance and prevent financial crimes. The role requires a Bachelor's degree and extensive experience in AM...Show more
    Last updated: 1 day ago • Promoted
    Investment Consultant- Columbia, MD

    Investment Consultant- Columbia, MD

    Charles Schwab • COLUMBIA, MD, United States
    Full-time
    Here, innovative thought meets creative problem solving, helping us “challenge the status quo” and transform the finance industry together. If you are seeking the first step towards a rich and rewar...Show more
    Last updated: 3 days ago • Promoted
    Coding Auditor

    Coding Auditor

    Children's National Health System • Silver Spring, MD, United States
    Full-time
    Description The Coding Auditor demonstrates expertise in coding and billing compliance while performing audits to determine billing integrity of professional and facility / technical fees including d...Show more
    Last updated: 3 days ago • Promoted
    (3542) DevOps Engineer

    (3542) DevOps Engineer

    Iamus Consulting • Columbia, Maryland, United States
    Full-time
    We are seeking a highly motivated and experienced DevOps Engineer to join our fast-paced development team.The ideal candidate will have strong working knowledge in Kubernetes and Container Orchestr...Show more
    Last updated: 30+ days ago • Promoted
    Remote Side Hustle Evaluator - Flexible Online Gig Work

    Remote Side Hustle Evaluator - Flexible Online Gig Work

    Finance Buzz • Highland, Maryland, US
    Remote
    Temporary
    Are you looking to earn extra income from the comfort of your home? We're seeking motivated individuals to explore and test a variety of remote side hustle opportunities featured on FinanceBuzz.Thi...Show more
    Last updated: 10 hours ago • Promoted • New!
    Travel Cath Lab Tech - $2,716 to $2,916 per week in Towson, MD

    Travel Cath Lab Tech - $2,716 to $2,916 per week in Towson, MD

    AlliedTravelCareers • Columbia, Maryland, US
    Full-time
    BCLS / BLS - American Heart Association / RCIS / ARRT(R).Titan Medical is looking for travelers to fill a Travel Cath Lab Tech position for a 13-week assignment in Towson, MD! Call Titan for additional d...Show more
    Last updated: 3 days ago • Promoted
    Microsoft Dynamics CE Technical Architect (Hiring Immediately)

    Microsoft Dynamics CE Technical Architect (Hiring Immediately)

    Guidehouse • COLUMBIA, MD, US
    Part-time
    Guidehouse has an exciting opportunity for a Microsoft Dynamics Architect to support our client's Case Management system. As an Architect, you will work with the technical team to design and deliver...Show more
    Last updated: 1 day ago • Promoted
    Board Certified Behavioral Analyst (BCBA)

    Board Certified Behavioral Analyst (BCBA)

    Apex ABA Therapy • Columbia, MD, US
    Full-time
    This job offers a generous Sign On Bonus!!.Special Opportunity for a Rockstar BCBA with great upside potential!.Looking for a rewarding and impactful career as a. Look no further than Apex ABA Thera...Show more
    Last updated: 30+ days ago • Promoted
    Travel Ultrasound Tech Job in Sykesville, MD - $10,546 per Month (2 Years Experience Needed)

    Travel Ultrasound Tech Job in Sykesville, MD - $10,546 per Month (2 Years Experience Needed)

    Vetted Health • Sykesville, MD, United States
    Full-time
    Must have 2+ years of experience.This contract pays approximately $10,546 / month gross.Guaranteed Pay : Never worry about canceled shifts. Premium Overtime : 2x hourly rate for overtime on travel assig...Show more
    Last updated: 3 days ago • Promoted
    Home Inspector (Salary $50-$85k)

    Home Inspector (Salary $50-$85k)

    House Buyers of America • Columbia, MD, US
    Full-time
    The Home Inspector is responsible for performing due diligence inspections on any properties acquired by House Buyers of America. Inspectors will also assist with construction and settlement tasks t...Show more
    Last updated: 5 days ago • Promoted
    OSINT Auditor

    OSINT Auditor

    Parsons Company • Fort Belvoir, VA, United States
    Full-time
    In a world of possibilities, pursue one with endless opportunities.At Parsons, you can imagine a career where you thrive, work with exceptional people, and be yourself. Guided by our leadership visi...Show more
    Last updated: 8 days ago • Promoted
    Inpatient Medical Coding Auditor

    Inpatient Medical Coding Auditor

    Humana • Washington, DC, United States
    Full-time
    Become a part of our caring community and help us put health first.The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate proce...Show more
    Last updated: 4 days ago • Promoted
    Certified Coding Auditor

    Certified Coding Auditor

    VirtualVocations • Arlington, Virginia, United States
    Full-time
    A company is looking for a Coding Auditor 1.Key Responsibilities Perform coding, auditing, editing, and review processes as required Provide guidance and feedback related to auditing, coding, an...Show more
    Last updated: 8 days ago • Promoted
    Coding Auditor & Educator

    Coding Auditor & Educator

    WelbeHealth • Washington, DC, United States
    Full-time
    WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range...Show more
    Last updated: 3 days ago • Promoted