E/M Coding Auditor

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

📋 Description

• Conduct regular E/M coding audits across designated specialties, providers, and client accounts.

• Review clinical documentation and coded encounters for precision, documentation alignment, and compliance.

• Assess patient status, place of service, level of service, modifiers, as well as add-on or prolonged services.

• Utilize AMA CPT E/M guidelines, CMS policies, ICD-10-CM, HCPCS, modifier rules, and payer-specific requirements.

• Complete assigned audit volumes within set turnaround expectations and quality standards.

• Execute assigned audits independently and escalate complex scenarios or conflicting guidance as necessary.

• Engage in audit calibration activities.

• Document audit findings, identify discrepancies, analyze root causes, and provide corrective recommendations.

• Prepare individual audit reports and summary submissions.

• Keep organized audit records and files.

• Gather audit data for trend analysis and reporting purposes.

• Communicate findings to the audited coders and providers.

• Offer E/M coding and documentation feedback and support audit-driven education.

• Re-audit previously identified findings to evaluate the effectiveness of corrective actions.

• Identify patterns and recurring documentation gaps, and report observations accordingly.

• Stay updated with AMA CPT E/M, CMS, payer, and regulatory developments.

• Highlight potential compliance risks and emerging accuracy issues.

• Assist with audit readiness activities and documentation for the audit program.

• Uphold confidentiality and protect patient health information in accordance with HIPAA regulations.

⛳️ Requirements

• Active CPMA along with one or more of the following: CPC, CCS, RHIT, RHIA is required.

• A minimum of 5 years of E/M coding experience, including at least 1 year of coding audit experience; 2+ years preferred.

• Comprehensive knowledge of current AMA CPT E/M and CMS documentation guidelines.

• Proficiency in Microsoft Office applications (Excel, Word, Outlook).

• Experience with reporting and data analysis tools is preferred.

• Proven capability to multi-task, prioritize tasks, and meet deadlines in a fast-paced environment.

• Strong communication and interpersonal abilities.

• Exceptional attention to detail and organizational capabilities.

• Ability to work independently while also contributing to a team-oriented environment.

• Demonstrated problem-solving skills with a proactive and solution-oriented mindset.

🏝️ Benefits

• Health insurance.

• Dental insurance.

• Vision insurance.

• Employee assistance plan.

• Paid family leave.

• Short-term disability insurance.

• Life insurance.

• 401(k) plan with employer match.

• Flexible spending accounts.

• Employee discount program.

• Employee referral program.