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Coding Auditor

Desert Oasis Healthcare • Palm Springs, CA, US • published 2026-09-29 08:55:30.927487

Description

The Coding Auditor is responsible for reviewing documentation and medical records to ensure accurate coding of services and diagnosis. This role will collaborate with providers to improve clinical documentation and ensure compliance with governmental and regulatory requirements. Professional Duties * Serve as a resource and subject matter expert for the coding team and providers to ensure the highest level of coding and documentation specificity. * Complete annual provider documentation validation audits, which includes but is not limited to: record requests, documentation review, provider report cards, and management reports. * Complete concurrent chart review for assigned providers. Report findings to department management and appropriate provider. * Collaborate with departmental management to coordinate Health Plan and Risk Adjustment Data Validation (RADV) audits to validate the accuracy of coding submitted by provider. Share results with departmental management and attend meetings with Health plans to discuss audit results. * Complete monthly prevalence review for targeted HCC categories and providers. Presents individualized results to each Provider, as necessary. * Utilize v...

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