Aetna Coding Quality Auditor in St Louis, Missouri

Req ID: 57310BR

POSITION SUMMARY

Performs vendor audits to ensure that all diagnosis codes are accurate and supported. Also assists with RADV, NRADV, and regulatory reviews.

Fundamental Components:

  • Minimum of 2 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing.

  • CPC (Certified Professional Coder) required

  • CRC preferred or received within 6 months of hire

  • Experience with ICD-10 codes required.

  • Experience with Medicare and/or Medicaid Risk Adjustment process required

  • Experience with Microsoft Office products (Word, Excel, Project, PowerPoint, Outlook).

  • Effective communications, organizational, and interpersonal skills.

  • Excellent analytical and problem solving skills

BACKGROUND/EXPERIENCE desired:

  • Minimum of 2 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing.

  • CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) required

  • CRC preferred or received within 6 months of hire

  • Experience with ICD-10 codes required.

  • Experience with Medicare and/or Medicaid Risk Adjustment process required

  • Experience with Microsoft Office products (Word, Excel, Project, PowerPoint, Outlook).

  • Effective communications, organizational, and interpersonal skills.

  • Excellent analytical and problem solving skills

EDUCATION

The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.

FUNCTIONAL EXPERIENCES

Functional - Medical Management/Medical Management - Coding/1-3 Years

Functional - Administration / Operations/Data Entry/1-3 Years

Telework Specifications:

FT Telework position/Work At Home (WAH)

ADDITIONAL JOB INFORMATION

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Aetna takes our candidates's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Job Function: Quality Management

Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.