Medical Auditor
S
Sprinter HealthHealthcare
Remote - United StatesTemporaryMiddle
Salary$33 base salary
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Job Details
- Experience
- Minimum 3 years of medical coding experience, with at least 1-2 years in a coding audit, QA, or compliance capacity.
- Required Skills
- ComplianceGoogle WorkspaceEHR
Requirements
- Active AAPC (CPC) or AHIMA (CCS-P, CCS) certification.
- Minimum 3 years of medical coding experience.
- Minimum 1-2 years in a coding audit, QA, or compliance capacity.
- Strong understanding of HCC / risk adjustment coding principles, clinical documentation improvement, and coding validation practices.
- Excellent command of medical terminology, anatomy, physiology, pathophysiology, disease progression, and pharmacology.
- Deep familiarity with CPT, ICD-10-CM, HCPCS, and modifier assignment.
- Proficient in EHR systems, encoder/coding software, and Google tools.
- Ability to work independently and maintain productivity in a remote setting.
- Strong communication and problem-solving skills.
- Reliable internet connection and dedicated, secure workspace.
Responsibilities
- Conduct routine and focused audits of medical coding to ensure compliance with CMS, payer, and organizational standards.
- Develop and deliver education and feedback to coders and providers to improve documentation quality and coding accuracy.
- Assist with internal and external audit preparation and response, including documentation requests and validation reviews.
- Maintain audit tracking logs, productivity reports, and accuracy metrics in accordance with company policies.
- Review medical records, claims data, and provider documentation to assess the accuracy of ICD-10-CM, CPT, HCPCS, and modifier assignment.
- Identify coding errors, trends, and opportunities for improvement; prepare detailed audit reports with actionable findings.
- Stay current with AAPC, AHIMA, CMS, and OIG guidelines, as well as payer policy changes and HCC model updates.
- Uphold all HIPAA, privacy, and compliance standards in handling patient data and audit documentation.
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