The Role
Audit ER medical records for accurate ICD-10-CM, CPT, HCPCS coding and E/M level selection; ensure payer/CMS/HIPAA compliance; prepare audit reports; train and mentor offshore coding teams; develop SOPs and training; track trends and assist denial management.
Summary Generated by Built In
Job Summary (Par time-Potential for Fulltime)
The Certified ER Medical Coding Auditor is responsible for auditing emergency department medical records to ensure accurate coding, compliance, and optimal reimbursement. This role also includes training and mentoring offshore coding teams to maintain high-quality standards and consistency across operations.
Key Responsibilities
One or more of the following:
The Certified ER Medical Coding Auditor is responsible for auditing emergency department medical records to ensure accurate coding, compliance, and optimal reimbursement. This role also includes training and mentoring offshore coding teams to maintain high-quality standards and consistency across operations.
Key Responsibilities
- Audit ER charts for accurate assignment of ICD-10-CM, CPT, and HCPCS codes
- Validate E/M level selection for emergency department visits
- Ensure compliance with payer guidelines and regulatory standards (CMS, HIPAA)
- Identify under coding, over coding, and documentation deficiencies
- Prepare detailed audit reports with corrective recommendations
- Provide education and feedback to coders and providers
- Train and mentor offshore coding teams on ER coding guidelines and audit findings
- Conduct regular quality review sessions and calibration meetings with offshore staff
- Develop and update training materials, Review SOPs, and coding guidelines
- Monitor offshore team performance and provide ongoing coaching
- Track audit findings and identify trends to improve coding quality
- Assist in denial management and revenue cycle improvement
- Stay current with coding updates and industry changes
One or more of the following:
- CPC / CPC-A (Certified Professional Coder)
- CCS (Certified Coding Specialist)
- COC (Certified Outpatient Coder)
- CPMA (Certified Professional Medical Auditor) – Highly Preferred
- Minimum 3–5 years of ER (Emergency Room) coding experience for facility and professional billing required
- At least 1–2 years of auditing experience
- Prior experience training or managing offshore teams preferred
- Strong knowledge of ER-specific coding and E/M guidelines
- Experience with EHR/EMR systems
Skills Required
- CPC or CPC-A certification
- CCS (Certified Coding Specialist) certification
- COC (Certified Outpatient Coder) certification
- CPMA (Certified Professional Medical Auditor)
- Minimum 3-5 years ER coding experience for facility and professional billing
- At least 1-2 years of auditing experience
- Prior experience training or managing offshore teams
- Strong knowledge of ER-specific coding and E/M guidelines
- Experience with EHR/EMR systems
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The Company
What We Do
Exceptional Healthcare is a premier leader in developing and operating community-based hospitals, focusing on improving the health and well-being of people in communities with limited healthcare resources. Their mission is to deliver compassionate, patient-centered emergency care and inpatient hospitalization services using a concierge care service standard, providing comprehensive emergency, trauma, and inpatient services across an expanding network of community hospitals.
