Children's National Hospital · 6 days ago
Coding Auditor
Silver Spring, MD
Full-time
Onsite
Entry, Mid Level
$64K/yr - $107K/yr
2+ years expChildren's National Hospital is dedicated to providing exceptional healthcare services, and they are seeking a Coding Auditor to ensure compliance in coding and billing practices. The role involves performing audits, evaluating documentation for accuracy, and ensuring adherence to healthcare billing standards.
AssociationChild CareHealth CareNon Profit
Responsibilities
Performs scheduled and unscheduled independent audits of professional fee documentation, coding and medical necessity related to professional service providers such as physicians and NPPs (Non-Physician Providers) as well as facility/technical fee billing audits (inpatient and outpatient) as assigned
Conducts specialized and focused audits
Evaluates the appropriateness and medical necessity of services and procedures billed based on supporting documentation
Evaluates the appropriateness of ICD-10, HCPCS and CPT codes, APC/EAPG, DRG, and admission assignments, along with modifier usage
Evaluates accuracy of supply and implant charge capture and coding based on Medical Center policies and related payor requirements
Makes determinations of overpayments and underpayments and performs other related analysis and evaluations
Adheres to the defined audit timeline and audit protocol standards
Assists with development of the audit schedule
Identifies services to be audited
Applies consistent and standardized billing audit methodology for sample selection, scoring and benchmarking development and reporting of findings. Reports findings in standardized format by established deadline so findings can be appropriately communicated
Maintains knowledge of current Medicare, Medicaid and other third party payor billing and documentation requirements
Meets department expectations about daily productivity targets and deadlines
Creates educational material for clinical and non-clinical staff
Other duties as assigned
Qualification
Required
Associate's Degree or 3 years of coding experience in lieu of the degree requirement
2 years as a Certified Coder
Interpret and apply documentation and coding rules and regulations along with charge capture and reimbursement methodologies
Plan, conduct and perform coding audits
Work cooperatively with Medical Center administrative staff, department staff, and providers
Manage diverse and conflicting priorities and projects effectively and meet deadlines
Maintain competence in and up-to-date knowledge of healthcare billing and coding compliance requirements, practices and trends
Conduct detailed coding audits, reach independent decisions and logical conclusions and prepare report of findings
Interpret medical records progress notes, hand written and electronic chart entries, provider orders, and other related documentation
Proficiency in the use of personal computers with Windows operating systems including Microsoft applications such as Word, Excel, Outlook, PowerPoint and Access
Communicate effectively both verbally and in writing
CCS, CIC, CPC, CPC-H, or COC certification
CPMA and/or CEMA/C or ability to acquire within 6 months after start date
Preferred
Experience in pediatric coding
Experience performing coding audits within an academic medical center
Company
Children's National Hospital
Children’s National Hospital, based in Washington, D.C., was established in 1870 to help every child grow up stronger.
Founded in 1870Washington, District of Columbia, USA
5001-10000 employees
H1B Sponsorship
Children's National Hospital has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (82)
2024 (55)
2023 (92)
2022 (59)
2021 (41)
2020 (51)
Funding
Current Stage
Late StageTotal Funding
$19.4MKey Investors
Gilbert Family FoundationAdvanced Research Projects Agency for HealthUnited Health Foundation
2025-10-09Grant· $8M
2024-10-23Grant· $8M
2021-11-09Grant· $3.4M
Leadership Team
Kurt Newman
President and CEO
Michelle Riley-Brown, MHA, FACHE
President and CEO
Recent News
BioWorld Financial Watch
2025-06-07
Company data provided by crunchbase