Exl Service

  • Outpatient Coding Auditor

    Job Location US-FL | US-FL-Jacksonville
    SCIO Healthcare Analytics
    Regular Full-Time
  • Overview

    EXL/SCIO Health Analytics is looking for an Outpatient Coding Auditor for our Jacksonville, FL location. This position has a great team of professionals and offers room for growth and advancement.


    The responsibilities of the Coding Auditor are to perform reviews by validating accuracy of the coding billed in relation to the medical documentation. The coding auditor determines if a discrepancy exists in the coding and documents the findings using standard documentation guidelines applicable to the program. The audits may be performed as desk or as a facility onsite. The coding auditor may need to travel to the providers location on an agreed upon schedule and perform the audit review.


    Key Duties and Responsibilities:
    • Reviews medical records and coding to validate Outpatient billing to include Professional, Hospital, APC assignment.
    • Responsible for updating SCIOmine (internal tool) with audit findings and completing audits assigned on a daily basis
    • Ability to write professional notes based on Scio Health Analytics policies using Official Coding guidelines, ICD-10 Coding Handbook, Coding Clinic and/or other recognized sources.
    • Review appeal information and render coding decision to either uphold or overturn original finding
    • Comply with all National Audit Employee Handbook policies and procedures - Comply with HIPAA and other regulations regarding confidentiality of information


    Knowledge and Skills:
    • Experience with: Excel, PowerPoint, Outlook, and Word
    • Experience with encoder tools (Optum, TrueCode, 3M, Webtrat, Pricers).
    • Sound knowledge of ICD-9, ICD-10, CPT and HCPCS coding guidelines.
    • Sound understanding of CMS, Medicare Advantage, Medicaid and Commercial billing practices,
    • Experience with and expertise with LCD, NCD.
    • High School Diploma
    • CCS or CPC
    • Minimum 3 years coding experience: Professional, Hospital, APC, ASC
    • Excellent verbal and written communication skills
    • Ability to work in the Jacksonville, Florida, office.
    • 5 years coding experience, RHIT or RHIA (degree)

    EEO Statement



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