This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Responsible for performing E/M audits, summarizing the results, communicating the outcomes to all parties and completing any follow up or educational needs as required. - Provide coding support for physicians. - Provide coding support for Claims Resolution Specialists. - Meet with Manager to discuss coding trends and report any coding issues. - Attend seminars and training sessions and report any changes or concerns to Manager/Compliance Officer. - Maintain and ensure the confidentiality of all patient and employee information at all times. - Assist in training new employees to related job duties. - Will be expected to work overtime when given sufficient notice of required overtime. - Comply with all Federal and State laws and regulations pertaining to patient care, patients’ rights, safety, billing, and collections. - Adhere to all Company and departmental policies and procedures, including IT policies and procedures and Disaster Recovery Plan. - Maintain all company equipment in safe and working order. - Complete E/M audits accurately in a timely manner as assigned to the Auditor Queue. - Contribute to the review and completion of tickets, emails and/or lists as assigned in a timely and accurate manner. - Contribute to the updating of Training Manuals, PowerPoints and SOP’s as well as work with peers while they are learning all the required duties of Coding Audits. - Provide Physician and extender training as needed. - Proficient in the use of the required programs to accomplish assigned work task and follow up as needed, including but not limited to Excel, Word, Outlook, and SharePoint. - Contribute to Government Audit Request as needed. - Performs other duties and projects as assigned. Qualifications - 2+ years coding experience with E/M experience in a medical office preferred. - CPC and/or CCS (Other AHIMA and/or AAPC certifications could be considered). Requirements - Critical thinking skills including solid problem solving, analysis, decision-making, planning, time management and organizational skills. - Developed interpersonal skills, emotional intelligence, diplomacy, tact, conflict management, delegation skills, and diversity awareness. - Good command of the English language; second language is an asset but not required. - Effective communication skills (oral, written, presentation) and active listening abilities. - Strong customer focus with the ability to build an engaging culture of quality, performance effectiveness and operational excellence. - Effectively manages own time, conflicting priorities, self, stress, and professional development. - Self-motivated and self-starter with ability to work independently with limited supervision. - Must be able to work effectively in a fast-paced, multi-site environment with demonstrated ability to juggle competing priorities and demands from a variety of stakeholders and sites. - Proficiency in MS Office Word, Excel, PowerPoint, and Outlook required.

• Conducting comprehensive claims payment quality reviews • Performing clinical coding compliance audits. • Communicating audit results to appropriate parties; recommending corrective course of action. • Reviewing the claims materials and medical record information submitted and assessing accuracy of provider submitted claims. • Planning and conducting investigations for certain claims; identifying potential subrogation or fraud. • Documenting audit results and supporting the development of audit policies and procedures.

• Conduct IT Audits: Plan and execute audits of IT systems, applications, and processes to assess compliance with applicable regulations and frameworks (ISO 27001:2022, NIST, HIPAA, GDPR, FedRAMP, etc.) • Risk Management: Identify, evaluate, and document IT and security risks. Recommend and track remediation activities through resolution. • Security Monitoring: Support operational security activities by reviewing logs, network traffic, and alerts to detect and respond to potential threats. • Control Assessment: Evaluate the design and operational effectiveness of technical, administrative, and physical controls across global environments. • Data Privacy Compliance: Ensure adherence to global privacy regulations, including GDPR and related data protection requirements. • Reporting: Develop clear, actionable audit reports summarizing findings, risks, and recommendations. Present key insights to IT and management teams. • Continuous Improvement: Contribute to strengthening ZOLL’s overall security posture and compliance maturity through process optimization and control enhancement. • Collaboration: Partner with IT, Security, and Compliance teams to support remediation and drive risk management improvements.

• Perform and lead a variety of coding-related audits for providers and other entities • Review medical records to verify that complete and accurate diagnosis codes are captured in claims and retrospective chart review data • Communicate audit results and recommendations for improvement to providers when needed • Create and maintain processes for tracking audit results and outcomes of reviews • Identify, track, analyze and report on any trends revealed in audits • Develop and maintain centralized policy, process and compliance-related documentation and training resources to support the education of providers and internal stakeholders • Lead the development of educational materials and process documentation in a variety of mediums • Actively maintain up-to-date knowledge of coding guidelines and applicable state and federal regulations • Maintain active coding certification • Seek out emerging coding best practices • Serve as subject matter expert regarding correct coding practices • Collaborate with Risk Adjustment team to create SOPs and contribute to roadmaps for Risk Adjustment Coding initiatives • Onboard and train new Coding Auditors