Claims Quality Auditor audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Selects claims through random processes and/or other criteria. Being a Claims Quality Auditor makes recommendations to improve quality, workflow processes, policies and procedures. Typically requires an associate degree. Additionally, Claims Quality Auditor typically reports to a supervisor or a manager. The Claims Quality Auditor gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Claims Quality Auditor typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
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The Coding Quality Auditor is responsible for monitoring compliance with applicable clinical documentation to support coding and billing regulations to insure appropriate reimbursement and to support public reporting and various initiatives as directed by Hackensack Meridian Health (HMH) Network.
This position is remote and candidates need to have a current CCS(Certified Coding Specialist) and 1-3 years experience in an acute care hospital conducting coding quality audits.
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