Coding Compliance Auditor

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

📋 Description

• Conduct thorough audits of inpatient and outpatient medical records to verify the correct assignment of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes.

• Ensure coding practices comply with CMS, OIG, AHIMA, AAPC, and specific requirements set by payers and clients.

• Analyze documentation and coding trends, compliance risks, and reimbursement opportunities through in-depth evaluation.

• Create clear and actionable audit reports that detail findings, recommendations, and avenues for process enhancement.

• Work in collaboration with coding leaders and operational teams to address coding discrepancies and improve documentation quality.

• Provide tailored education to coders and clinical staff, based on audit outcomes and updates in regulatory guidance.

• Track coding quality metrics and propose strategies to enhance coding accuracy, compliance, and overall performance.

• Remain updated on coding revisions, reimbursement strategies, and healthcare regulations to ensure the consistent application of best practices.

⛳️ Requirements

• A minimum of 4 years of experience in acute care inpatient and outpatient coding, including quality or compliance auditing.

• Proven proficiency with ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding systems.

• Possession of one or more active credentials such as CCS, RHIA, RHIT, CPC, or CIC.

• Strong knowledge of Medicare reimbursement methodologies, including MS-DRGs, IPPS, OPPS, and relevant federal coding guidelines.

• Experience in interpreting clinical documentation and recognizing opportunities to enhance coding accuracy and compliance.

• Exceptional analytical, communication, and written reporting abilities.

• Capability to provide constructive feedback and educational support to promote coder development.

• Comfortable working autonomously while collaborating with cross-functional healthcare teams in a remote setting.

• Proficient in using EHR Epic.

🏝️ Benefits

• Medical, Dental & Vision Insurance

• 401(k) with Company Match

• Paid Time Off & Paid Holidays

• Flexible Spending Accounts (FSA)

• Opportunities for Professional Growth & Career Development

• Fully Remote Work Environment

• Supportive, Collaborative Team Culture