Physician Coding Auditor

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

📋 Description

• Review and accurately code professional multi-specialty services, encompassing evaluation and management, diagnostics, surgeries, and procedures.

• Conduct professional compliance audits of coding and documentation across various provider types, specialties, and clients.

• Implement ICD-10-CM, CPT, AHA Coding Clinics, AMA, CMS, specialty association, and other relevant coding guidelines.

• Select CPT codes and apply the appropriate modifiers.

• Choose and assess ICD-10-CM diagnosis codes.

• Analyze physician documentation quality and medical necessity.

• Comply with LCDs, NCDs, NCCI edits, and payer-specific policies when applicable.

• Review documentation for split/shared or incident-to services, Teaching Physician Guidelines, FQHCs, RHCs, and HEDIS.

• Score audits utilizing the correct scoring methodology.

• Identify risk areas and propose mitigation strategies and recommendations.

• Compile detailed findings and supporting documentation into customized reports.

• Prepare and deliver audit follow-up education to clients.

• Develop and present customized educational materials both remotely and on-site.

• Communicate with the Physician Audit and Education Manager regarding issues, trends, and the completion timeline for audits.

• Stay updated on coding guidelines and maintain credentials.

• Participate in departmental and educational meetings.

• Uphold confidentiality and safeguard sensitive information.

• Execute other responsibilities as assigned by leadership.

⛳️ Requirements

• High School diploma is required.

• Successful completion of at least one AHIMA or AAPC certification program, holding a corresponding professional credential (e.g., CCS-P, CPC, or another relevant AAPC stand-alone credential), active and in good standing.

• A minimum of 5 years of recent physician coding experience is required.

• At least 3 years of recent physician auditing experience is required.

• Subject matter expert in E&M and Surgical coding.

• Extensive knowledge of medical terminology, anatomy and physiology, disease processes, CPT coding and AMA guidelines, ICD-10-CM coding and guidelines, along with Medicare and Medicaid billing policies for professional services.

• Experience in creating and executing audit plans.

• Proven experience in educating providers either one-on-one or in group settings.

• Ability to work independently, with excellent time management, research and organizational skills, capability to juggle multiple projects, and meet project deadlines.

• Proficiency with Microsoft Word, Excel, PowerPoint, Windows, and healthcare information and billing systems.

• An Associate or BS degree is preferred.

• AAPC CPMA credential is preferred but not mandatory.

• Proficiency in Google Workspace is preferred but not mandatory.

• Remote work experience is preferred but not required.

• Experience with multiple common EMRs is advantageous.

• Specialization in the specified profee areas is a plus.

🏝️ Benefits

• Flexible schedule.

• Opportunities for professional development and education.

• Permanent positions; no contracts or coding bench.

• Generous paid time off.

• Holiday pay.

• Flexible scheduling throughout the year.

• Up to 100% employer-paid medical, dental, and vision benefits for employees.

• 401K and profit sharing.

• STD, LTD, life insurance, and FSA program.

• Paid AAPC and AHIMA corporate memberships.

• 30 hours of CEU pay (continuance in education).

• Access to an internal network of Medical Coding Industry Leaders.

• National recognition as a Best Place to Work.