Lead Healthcare Coding Quality Auditor

This is a fully remote position, open to applicants in Egypt, +1 more country.

📋 Description

• Conduct retrospective, concurrent, and prospective coding audits for inpatient, outpatient, physician, and specialty services.

• Evaluate medical documentation to ensure the accuracy and completeness of diagnosis and procedure codes.

• Guarantee adherence to ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, Medicare, Medicaid, commercial payer, and regulatory standards.

• Detect coding mistakes, documentation deficiencies, and potential reimbursement opportunities.

• Compile audit reports that include findings, trends, recommendations, and corrective actions.

• Deliver individual and group training to coders, providers, and clinical personnel.

• Track coding quality metrics and formulate action plans to enhance accuracy and consistency.

• Remain updated on coding regulations, CMS guidelines, payer policies, and industry best practices.

• Assist in both internal and external audits, payer reviews, and regulatory investigations.

• Engage in policy formation, process enhancement initiatives, and coding education programs.

• Monitor audit outcomes and recognize recurring trends for ongoing quality improvement.

⛳️ Requirements

• A minimum of 3–5 years of medical coding experience within a healthcare environment.

• At least 2 years of coding audit or quality review experience is preferred.

• Current coding certification such as CPC, CPMA, CCS, or CIC is required.

• RHIT or RHIA certification is preferred.

• In-depth knowledge of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding systems.

• Strong comprehension of CMS regulations, NCCI, Official Coding Guidelines, and payer-specific policies.

• Experience with electronic health records and encoder software.

• Familiarity with healthcare reimbursement methodologies.

• Ability to interpret complex clinical documentation effectively.

• Proficiency in Microsoft Office Suite and coding/audit software.

• Outstanding analytical and critical thinking abilities.

• Excellent written and verbal communication skills.

• Keen attention to detail and strong organizational skills.

• Capability to maintain objectivity while delivering constructive feedback.

• Ability to work both independently and collaboratively in a fast-paced environment.

• Commitment to maintaining confidentiality of PHI in compliance with HIPAA regulations.

🏝️ Benefits

• Full-time employment.

• Confidential management of employee information in accordance with EEO guidelines.

• Protections under equal employment opportunity policies.

• Voluntary Administrative EEO record disclosure; participation does not influence employment decisions.