Professional Fee Coding Auditor

New

JobgetherHealthcare coding

Work arrangement: Fully remote within the United States.Full-TimeJunior

Salary38 USD per hour

Apply NowOpens the employer's application page

Job Details

Languages: English-language proficiency required for system access.
Experience: At least two years of professional coding experience in the applicable coding area; at least three years of consultant experience reviewing records in large tertiary-care hospitals and outpatient organizations serving primary care and subspecialty populations; at least three years of education and training experience.

Hold an active RHIA, RHIT, CCS, CCS-P, CPC, or CPC-H credential from an accepted professional organization.
Have at least two years of professional coding experience in the applicable coding area.
Have at least three years of consultant experience reviewing records in large tertiary-care hospitals and outpatient organizations serving primary care and subspecialty populations.
Have at least three years of education and training experience, including presenting audit findings and delivering facility-specific coding education.
Demonstrate strong knowledge of ICD-10-CM, CPT, HCPCS Level II, evaluation and management services, modifiers, professional components, bundling, reimbursement, documentation, and coding compliance requirements.
Be able to evaluate provider documentation and determine whether reported professional services and codes are adequately supported.
Maintain at least 95% audit accuracy while meeting reporting and turnaround requirements.
Complete a Low Risk NACI background investigation and required privacy, information-security, and mandatory training.
Work securely from an approved location within the United States and protect sensitive healthcare information.
Provide a current resume, signed Letter of Intent, completed candidate cover page, proof of active credentials, and two current client references specific to the individual reviewer.

Independently audit inpatient and outpatient professional-fee coding for accuracy, documentation support, compliance, and reimbursement impact.
Evaluate ICD-10-CM, CPT, HCPCS Level II, evaluation and management, professional-component, modifier, and bundling assignments.
Verify provider information, scope of practice, billability, and documentation supporting reported professional services.
Review diagnoses and procedures in electronic health records and approved audit tools according to established sampling requirements.
Identify incorrect, missing, unbundled, upcoded, downcoded, unsupported, or otherwise noncompliant codes and modifiers.
Document audit findings with supporting authority, financial impact, risk assessment, and recommended corrective action.
Participate in calibration activities and maintain a minimum audit accuracy of 95%.
Contribute to audit work plans, data collection tools, facility reports, consolidated reporting, and progress updates.
Prepare or support final reports on coding accuracy, documentation deficiencies, financial impact, process improvement opportunities, and educational needs.
Develop and deliver facility-specific coding education and support exit conferences when required.

View Full Description & ApplyYou'll be redirected to the employer's site