Professional Fee Auditor – ProFee

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

📋 Description

• Accountable for reviewing professional fee (ProFee) physician coding to ensure accuracy, compliance, and adequate documentation support.

• This position identifies potential risks, guarantees coding consistency, and delivers constructive feedback to enhance overall coding quality.

• Conduct retrospective and/or concurrent audits of professional fee coding.

• Validate the selection of CPT, HCPCS, ICD-10-CM codes, and the use of modifiers.

• Adhere to AHIMA’s Standards of Ethical Coding, relevant regulations and guidelines, as well as client-specific policies.

• Identify trends, risks, and areas for improvement in coding practices.

• Offer clear, actionable audit feedback and educational support to coding staff.

• Maintain established quality metrics (e.g., ≥95% coding accuracy) and comply with productivity standards.

⛳️ Requirements

• Credentials: CPC, CPMA, CCS, RHIA, or RHIT (active).

• Experience: Minimum of 3+ years in professional fee auditing with at least 2 years of auditing experience. Alternatively, 7+ years of coding experience is required if auditing experience is not applicable. Previous coding experience is highly preferred.

• Experience in auditing physician services, preferably from hospital-based or large practice settings.

• Strong understanding of RVU and CPT/HCPCS, ICD-10-CM, modifiers, and NCCI edits.

• Excellent written communication skills and meticulous attention to detail.

🏝️ Benefits

• National exposure to a variety of high-acuity health systems and specialties.

• Quality-first culture with realistic expectations (not solely focused on volume).

• Flexible work arrangements (full-time, part-time, and PRN).

• Opportunities to expand into additional audit, education, and advisory services.