[Hiring] Medical Auditor II @Amazon
Role Description
As a key member of the Amazon One Medical Revenue Cycle team, the Medical Auditor will be responsible for supporting Amazon One Medical Clinical and Revenue Cycle teams in managing and optimizing compliant healthcare revenue cycle operations. This role reports into the Coding Compliance Auditing Manager, Revenue Cycle.
Key job responsibilities:
• Conduct regular audits to verify accuracy of ICD-10-CM, CPT, HCPCS, and modifier medical codes
• Review documentation to verify appropriate code assignment
• Ensure coding reflects clinical documentation and meets medical necessity requirements
• Identify coding inaccuracies and opportunities for improvement
• Track and report coding errors and findings
• Maintain detailed records of audit findings
• Ensure adherence to coding guidelines and regulatory requirements
• Follow established policies and procedures, and surface and escalate compliance concerns as appropriate
• Experience using data to drive root cause elimination and process improvement
Qualifications
• 3+ years of data analysis and formula creation in Microsoft Excel experience
• CPC certification through AAPC or CCS certification through AHIMA
• 3+ years of coding/auditing experience in the professional fee and/or risk adjustment setting working with Medicare, Medicare Advantage, and Commercial payers required
• Knowledge of industry standard code sets and associated guidelines (ICD-10-CM, CPT, HCPCS)
• Advanced knowledge and understanding of HCC Risk Adjustment, coding and documentation requirements
• Strong written and verbal communication with attention to detail
• Strong organizational, analytical, problem solving, and time management skills
• Experience with end-to-end project management
• Experience prioritizing and handling multiple assignments at any given time while maintaining commitment to deadlines, or experience in a fast-paced, high-tech company
• Bachelor’s Degree in healthcare related field
• Demonstrated ability to identify and communicate trends in coding and documentation
Requirements
• Ability to adhere to company policies
• Exercise sound judgment
• Effectively manage stress and work safely and respectfully with others
• Exhibit trustworthiness and professionalism
• Safeguard business operations and the Company’s reputation
Benefits
• Comprehensive health insurance (medical, dental, vision, prescription)
• Basic Life & AD&D insurance and option for Supplemental life plans
• EAP, Mental Health Support, Medical Advice Line
• Flexible Spending Accounts
• Adoption and Surrogacy Reimbursement coverage
• 401(k) matching
• Paid time off
• Parental leave
Apply Now
Apply Now
As a key member of the Amazon One Medical Revenue Cycle team, the Medical Auditor will be responsible for supporting Amazon One Medical Clinical and Revenue Cycle teams in managing and optimizing compliant healthcare revenue cycle operations. This role reports into the Coding Compliance Auditing Manager, Revenue Cycle.
Key job responsibilities:
• Conduct regular audits to verify accuracy of ICD-10-CM, CPT, HCPCS, and modifier medical codes
• Review documentation to verify appropriate code assignment
• Ensure coding reflects clinical documentation and meets medical necessity requirements
• Identify coding inaccuracies and opportunities for improvement
• Track and report coding errors and findings
• Maintain detailed records of audit findings
• Ensure adherence to coding guidelines and regulatory requirements
• Follow established policies and procedures, and surface and escalate compliance concerns as appropriate
• Experience using data to drive root cause elimination and process improvement
Qualifications
• 3+ years of data analysis and formula creation in Microsoft Excel experience
• CPC certification through AAPC or CCS certification through AHIMA
• 3+ years of coding/auditing experience in the professional fee and/or risk adjustment setting working with Medicare, Medicare Advantage, and Commercial payers required
• Knowledge of industry standard code sets and associated guidelines (ICD-10-CM, CPT, HCPCS)
• Advanced knowledge and understanding of HCC Risk Adjustment, coding and documentation requirements
• Strong written and verbal communication with attention to detail
• Strong organizational, analytical, problem solving, and time management skills
• Experience with end-to-end project management
• Experience prioritizing and handling multiple assignments at any given time while maintaining commitment to deadlines, or experience in a fast-paced, high-tech company
• Bachelor’s Degree in healthcare related field
• Demonstrated ability to identify and communicate trends in coding and documentation
Requirements
• Ability to adhere to company policies
• Exercise sound judgment
• Effectively manage stress and work safely and respectfully with others
• Exhibit trustworthiness and professionalism
• Safeguard business operations and the Company’s reputation
Benefits
• Comprehensive health insurance (medical, dental, vision, prescription)
• Basic Life & AD&D insurance and option for Supplemental life plans
• EAP, Mental Health Support, Medical Advice Line
• Flexible Spending Accounts
• Adoption and Surrogacy Reimbursement coverage
• 401(k) matching
• Paid time off
• Parental leave
Apply Now
Apply Now