Job Summary

We are seeking a detail-oriented and analytical Internal Auditor with Medical Coding Certification to join our team. The ideal candidate will play a critical role in evaluating and improving the effectiveness of our internal controls, billing and auditing governance processes. This position requires a strong understanding of medical coding, including ICD-9 and ICD-10, as well as familiarity with medical terminology and records. The Internal Auditor will work closely with various departments to ensure compliance with regulations and standards while identifying areas for improvement.

Responsibilities

• Displays courtesy, tact, and diplomacy when dealing with employees, physicians, and outside institutions.
• Identifies risk areas, creates an audit strategy, requests correct reports, concisely identifies the issues and provides recommendations for effective corrective actions.
• Participates actively and enthusiastically in identifying project issues and workflow.
• Contributes recommendations in project issue resolution.
• Conducts follow-up review with requesting/reviewed departments to ensure points of clarification on items are met.
• Collecting, validating, and analyzing data related to project and extracting and interpreting data to summarize findings.
• Maintain current industries knowledge.
• Manages time efficiently to meet assigned tasks deadlines as required.
• Must be comfortable working from and updated internal ticketing system in an organized and timely manner.
• Collecting, validating, and analyzing data related to projects and extracting and interpreting.
• Must be comfortable and willing to share knowledge and historical project information to train.
• Must be willing and able to research and interpret policies and guidelines as needed for projects.

Experience and Skills

Education:

• Bachelors or Associate degree
• Two (2) to five (5) years’ experience

Skills and Knowledge:

• Ability to work under nominal supervision performing duties in an area where procedures are standardized by independent decisions are required.
• Ability to multitask.
• Proficient in Epic applications/knowledge of company operating systems
• Full knowledge of medical terminology, ICD-10-CM and CPT guidelines
• Full knowledge of NYS Medicaid and Third-Party Regulations.
• Knowledge of CMS Regulations.
• Computer literacy.
• Microsoft Suite proficient.
• Good organizational and communication skills.

Licenses/Certifications Required:

• Certified Professional Coders (CPC) or
• Certified Coding Specialists (CCS) or
• Certified Coding Specialists Physicians (CCSP) or
• Certified Outpatient Coder (COC) or
• Certified Professional Medical Auditor (CPMA) desirable
• Other Specialty Certification

Join our team as an Internal Auditor where your expertise will contribute significantly to our commitment to excellence in healthcare operations.