Outpatient Auditor - Lakeland Florida

Company: VirtualVocations
Location: Lakeland, Florida
Posted On: 01/28/2025

A company is looking for an Auditor III - Outpatient.



Key Responsibilities:

Conduct CPT/APC coding reviews to verify accuracy of CPT coding assignments and APC reimbursement on outpatient claims
Apply Medicare, NCCI, and other coding guidelines to various claim scenarios and utilize tools for overpayment identification
Document audit results effectively using AHA Coding Clinic Guidelines and CPT coding rules


Required Qualifications:

One or more credentials such as CCS, RHIA, RHIT, or CPC; preference for multiple credentials
3+ years of outpatient coding experience with expert knowledge of AHA and CPT Coding Guidelines
Familiarity with APC reimbursement methodologies and healthcare payer contract language
Preferred experience in APC retrospective overpayment identification auditing More...

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