Auditor

This is a fully remote position, open to applicants in Florida, +8 more states.

📋 Description

• Act as a bridge between the practice and patients, as well as between the practice and outsourced Revenue Cycle Management (RCM) providers.

• Evaluate professional fee billing, coding, and documentation.

• Conduct audits of physician billing practices to ensure alignment with medical record documentation and compliance with federal, state, and third-party standards.

• Execute timely compliance and operational reviews in accordance with the current OIG Workplan and compliance risk assessments.

• Recognize compliance risks and opportunities for revenue enhancement.

• Ascertain necessary corrections and refunds arising from compliance audits and oversee their completion.

• Examine areas that require improvement in documentation.

• Compile written reports.

• Offer education and training as required.

• Perform follow-up reviews when needed.

• Convey findings and suggestions for enhancements.

• Stay updated with governmental, state, and payer-specific rules regarding documentation, coding, and billing.

• Address inquiries from coworkers and staff related to coding and compliance matters.

⛳️ Requirements

• Coding certifications (AAPC or AHIMA) and CPMA are mandatory.

• In-depth knowledge of coding disciplines.

• Strong understanding of medical terminology, billing, and payment methodologies.

• Familiarity with ICD-10, CPT, HCPCS, and E/M coding guidelines.

• Extensive knowledge of procedure and diagnostic coding for professional services.

• Awareness of Medicare, Medicaid, and other third-party payer coding and billing regulations.

• Understanding of the 1995 and 1997 Evaluation and Management Documentation guidelines.

• Knowledge of professional documentation requirements.

• Exceptional verbal, written, and interpersonal communication skills.

• Proficient computer skills, including Microsoft Office, Excel, and Word.

• Capability to multitask and meet various deadlines while under pressure.

• Knowledge and comprehension of HIPAA rules and regulations.

• Must be a resident of Pennsylvania, Maryland, New Jersey, Delaware, Texas, Tennessee, West Virginia, Indiana, Georgia, Florida, or Ohio.

• Must have authorization to work in the US for any employer.

• Ability to occasionally stand, walk, sit, and reach with hands and arms.

• Occasionally able to lift or move up to 25 pounds.

🏝️ Benefits

• Fully remote work opportunity.

• Full-time, 8-hour shift with a Monday–Friday work schedule.

• Equal Opportunity Employer.