Professional Coding Auditor

This is a fully remote position, open to applicants in Alabama, +13 more states.

📋 Description

• Ensure the precision, thoroughness, and adherence to standards in medical coding and documentation for professional coding services.

• Review patient records, clinical documentation, and coded information to detect discrepancies and coding challenges.

• Collaborate with healthcare professionals, coders, and compliance teams.

• Enhance appropriate reimbursement and reduce compliance risks through meticulous coding reviews.

• Conduct in-depth chart examinations to assess coding accuracy and the quality of documentation.

• Evaluate provider documentation for proper coding and adherence to regulatory standards.

• Participate in regular audits.

• Offer education and training on coding standards and documentation enhancement.

• Analyze coding data to uncover trends, opportunities for improvement, and compliance risks.

• Produce detailed audit reports that include findings and recommendations.

• Audit medical coding in accordance with ICD-10, CPT, HCPCS, payer guidelines, regulatory requirements, and internal policies.

• Monitor compliance with CMS guidelines and HIPAA standards and suggest corrective measures.

• Document audit processes, outcomes, and issues.

• Stay updated on coding guidelines, healthcare regulations, and industry best practices.

• Engage in workshops, seminars, and continuing education programs as necessary.

⛳️ Requirements

• A high school diploma or equivalent is required.

• Coding certification from a nationally recognized organization such as AAPC or AHIMA is mandatory (CCS-P, CPC, RHIA, RHIT, CCS, CPC-H).

• A minimum of two years of experience in a medical billing or coding office is required.

• Equivalent combinations of education and experience may be evaluated.

• Preferred: Two years of post-secondary education in a business or medical-related field.

• Preferred: Experience in medical management.

• Ideally, two years of experience in a medical billing, coding, or healthcare revenue cycle environment.

• Preferred experience with medical coding, auditing, or chart reviews in a healthcare context.

• Familiarity with electronic health record (EHR) systems is preferred.

• Strong understanding of medical terminology, anatomy, and coding systems is essential.

• Excellent written and verbal communication skills are required.

• Comprehensive understanding of healthcare regulations and compliance standards.

• Exceptional attention to detail and accuracy in reviewing documentation.

• Capability to analyze coding data and identify discrepancies or areas for improvement.

• Applicants must be physically located and authorized to work in Alabama, Arkansas, Florida, Georgia, Illinois, Louisiana, Michigan, New Hampshire, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, or Wisconsin.

🏝️ Benefits

• Comprehensive health benefits that begin on day one.

• Assistance and reimbursement programs for student loan repayment.

• Family-oriented benefits.

• Wellness incentives.

• Continuous mentorship, development, and leadership programs.