Medical Coder – Audit Specialist

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

📋 Description

• Evaluate medical records and associated documentation for accuracy in coding and adherence to Indiana Health Coverage Programs, CMS, AMA, and relevant standards and regulations.

• Perform coding and documentation assessments independently and share preliminary results with the Lead Reviewer.

• Detect discrepancies in coding, documentation shortfalls, and billing compliance challenges.

• Maintain comprehensive workpapers that document procedures, records assessed, findings, and conclusions.

• Support audit responses and appeals processes.

• Ensure alignment with state, federal, and national coding and reimbursement standards.

• Keep up-to-date with CPT, HCPCS, ICD-10-CM, Medicaid coding guidelines, policies, and regulatory changes.

• Investigate Indiana Medicaid regulations and manage repositories of bulletins, policies, and procedures.

• Adapt to evolving priorities, policies, regulatory changes, and review requirements while ensuring precision and meeting deadlines.

⛳️ Requirements

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

• Minimum of 1 year of experience in medical coding, claims review, billing compliance, or related healthcare reimbursement fields.

• Preference for candidates familiar with Indiana Medicaid policies, payer guidelines, and documentation standards.

• Candidates residing in or near the Indianapolis area are preferred.

• Proficiency in Microsoft Excel, Word, and Outlook is essential.

• Strong analytical, critical thinking, problem-solving, and technical writing capabilities are necessary.

• Ability to work both independently and as part of a team in a dynamic environment.

• Experience collaborating with healthcare providers is strongly preferred.

• Knowledge of healthcare claims data and issues related to fraud, waste, and abuse is preferred.

• Capability to talk or hear, sit, and utilize technology tools such as a laptop for extended durations.

• Close vision and the ability to adjust focus are required.

• Must meet the essential physical demands of the role, with reasonable accommodations available.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Generous paid time off and holiday schedule.

• Retirement savings plan with company match.

• Opportunities for professional development and continuing education.

• Flexible work arrangements.