Outpatient Innovations Auditor

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

📋 Description

• Conduct scheduled quality assurance evaluations for clients.

• Assess Autonomous Coding records for accuracy, completeness, and suitability of AI-generated ICD-10-CM, CPT, and HCPCS code assignments.

• Contrast AI-generated outcomes with human-coded results and source documentation.

• Document discrepancies in coding and provide rationale for final conclusions.

• Analyze patterns of variance, false positives, false negatives, and workflow exceptions.

• Raise concerns regarding compliance, configuration, or performance.

• Collaborate with clients, the Innovations team, Coding Operations, and other stakeholders.

• Clarify requirements, review findings, resolve inconsistencies, and suggest improvements in coding logic, workflow, and quality control.

• Assist in solution validation, user acceptance testing, release readiness, and post-implementation monitoring.

• Ensure reproducible audit documentation and summarize findings related to accuracy, variance, and trends.

• Communicate quality-related issues to management and address client QA requests.

• Manage patient information in compliance with HIPAA regulations.

• Participate in educational conference calls.

• Uphold required standards for productivity, quality, turnaround time, and documentation.

• Maintain an audit accuracy rate of 95% or higher.

• Perform additional tasks within the project scope.

⛳️ Requirements

• Valid AHIMA or AAPC coding credential.

• At least 5 years of coding experience.

• Familiarity with all facets of outpatient charts, including SDS, ED, Ancillary, Observations, and IVR.

• Minimum of 2 years auditing experience.

• Preferred experience in auditing technology-assisted, computer-assisted, or autonomous coding results.

• Ability to interpret audit findings, analyze coding variances, and communicate evidence-based recommendations.

• Preferred 2 years of experience in a remote work setting.

• Proficient in electronic health records, encoder or coding platforms, audit tools, and spreadsheet-based data review.

• Knowledge of HIPAA Privacy and Security Regulations.

• Must maintain coding credential requirements.

• Strong skills in collaboration, analysis, problem-solving, communication, presentation, time management, and organization.

• Capability to self-motivate and self-direct.

• Commitment to a team-oriented environment and adherence to company Core Values.

🏝️ Benefits

• Part-time employment.

• Fully remote work arrangement.

• Home office environment.

• Equal opportunity employment.