Inpatient and Outpatient Coding Compliance Auditor - (Gardner, MA)

The Inpatient and Outpatient Coding Compliance Auditor will provide expert auditing services across various hospitals for Inpatient and all Outpatient services. Review documentation and related coding of inpatient and outpatient services, auditing correct assignment of CPT, ICD - ten - CM / PCS, HCPCs, to verify coding and billing accuracy and that coders base code assignment in a manner consistent with relevant laws, regulations, coding and billing standards. This individual will provide education to coders on audit results, utilize ability to research and respond to challenging coding questions, develop and provide coding education and evaluate audit results to recommend corrective actions. The individual will have the ability to respond to client requests to conduct ad hoc coding and billing audits. Main responsibilities: Perform coding compliance and quality audits in support of Optum360's Compliance Program and client expectations o Analyze and interpret documentation from medical records