• Auditor (Internal)

    Req No
    Regular Full-Time
  • Overview

    Stability & Reputation – Founded in 2004, Peak Health Solutions delivers a superior set of solutions to hospitals that are some of the largest and most prestigious in the country. Peak recognizes coding isn't a project it is a Career! Keeping our coders consistently engaged is the #1 reason coders stay with Peak.


    Rare opportunity –This is a unique opportunity to work for some of the nation's top hospitals, you will be a full time employee working 100% remotely from your location while receiving full company benefits.  We offer online training and career advancement opportunities. Due to our diverse customer base, a background working with a wide variety of specialties will be required.


    Support - Here at Peak, you work directly with a Sr Manager who has walked in your shoes. They will give you the guidance and assistance you need to be successful in your career here with us.


    Compensation and Benefits – Peak Health Solutions offers competitive compensation and a benefits package that includes: ICD-10 Training, Benefits, Paid Time Off, 401k and CEU reimbursement.

    Employee Recognition – Employees will also participate in our company-wide rewards program entitled REACH – Recognizing Excellence, Accomplishments, Character and Hard work! 


    Under the direction of the Sr Mgr of Quality & Education, the multi-faceted auditor performs departmental and interdepartmental coding audits to ensure compliance with Federal and State Regulations. Has thorough knowledge of Acute Care Facility and Professional Coding Federal and State reporting guidelines, evaluation and management code assignments, modifiers, sequencing rules and the NCCI (National Correct Coding Initiative) edits, Offical Guidelines for Coding and Reporting for ICD-10-CM, CPT-4 coding conventions, DRG and APC payment classifications and Medicare Conditions of Participation. The auditor will identify cases coded incorrectly and provide feedback, supporting documentation for changes, and education to the coder.


    Will identify educational opportunities and educate and train coding staff accordingly. Will provide inter-departmental coding support when needed. Will assist the Coding Managers on preparing presentations and or inter-departmental feedback. Other duties will include implementing coding department policies and procedures. The auditor will also report cases containing deficient documentation (missing, ambiguous or contradictory) thus needing to clarify diagnoses, and procedures.  The auditor will provide feedback to clients/facilities regarding coding quality as needed.



    • Associate Degree or equivalent education/experience and at least five years of experience in hospital facility inpatient,outpatient and professional fee coding, auditing and related work.
    • CCS, CCS-P, CPC, CPC-H
    • Demonstrates effective communication, interpersonal skills, organizational ability, knowledge of proper body mechanics, safety measures and infection control, ability to follow instructions, knowledge of section specific test information and instrumentation may be required.
    • Knowledge of Microsoft Office applications including email, Word and Excel.Must have strong knowledge of CMS Conditions of Participation, Medicare and Medi-Cal hospital documentation requirements and Official Guidelines for Coding rule, ICD-10/CPT/HCPCS/DRG coding rules, acute care hospital facility charge capture and reimbursement methodologies, including DRG, APC, CPT, ICD, HCPCS, etc.
    • Advanced documentation and coding skills, with experience in one or more of the following hospital/technical documentation and coding areas: 1995/1997 Documentation Guidelines,  MSDRG/APR DRG, APC, ICD/HCPCS/CPT, Medi-Cal, Clinical Documentation Improvement programs and/or medical necessity determination.
    • Must be able demonstrate ability to work independently with remote supervision.


    • RHIT w/ CCS, CPC 
    • Strong written and oral communication skills are a must.  

    Peak Health Solutions, an AMN Healthcare company, is an EEO/AA/Disability/Protected Veteran Employer We encourage minority and female applicants to apply


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