Coding Compliance Audit – Education Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Review medical records to ensure adherence to federal coding regulations and guidelines.

• Perform baseline, routine periodic, and focused audits to compare documentation with CPT/HCPCS and ICD-10-CM codes.

• Investigate, interpret, and relay federal and state laws along with CMS/Medicare guidelines.

• Serve as an internal authority on coding compliance matters.

• Generate audit reports that summarize findings.

• Provide post-audit education for individual providers and large provider groups.

• Arrange training sessions with provider offices and practitioners.

• Offer feedback, education, training, and technical assistance on documentation, service selection, charge capture, supervision, timely submissions, healthcare data accuracy, and coding principles.

• Relay audit findings to providers and monitor the completion of educational initiatives and necessary escalations.

• Deliver coding assessments, consultations, education, and resolution of issues to stakeholders.

• Engage in discussions with providers regarding compliance, documentation, and code assignment challenges.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• A minimum of 5 years of experience in audit and provider education is preferred.

• In-depth knowledge of CPT, ICD-10, and HCPCS codes and their respective guidelines.

• Certification as a Professional Coder (CPC) is required.

• Certification as a Professional Medical Auditor (CPMA) is preferred.

• Experience with MDAudit and Athena is advantageous.

• Must adhere to all HIPAA rules and regulations.

• Strong communication skills are essential.

• Ability to work independently is required.

• Minimum internet speed of 5 MBPS download and 3 MBPS upload is necessary for remote work.

• Must be able to work remotely from within the United States.

🏝️ Benefits

• Annual bonus aimed at 15%.

• Medical insurance coverage.

• Dental insurance included.

• Vision insurance provided.

• Life insurance available.

• Pet insurance options.

• 401K retirement plan.

• Paid time off.

• Wellness programs offered.

• Opportunity for remote work.

• Expense reimbursement for employees who consistently work from home offices.

• EEO-protected work environment.