Medical Coding Auditor / Coding Validation Reviewer

JobgetherHealthcare coding

100% remote position available to candidates in the United States.ContractMiddle

Salary25 - 30 USD per hour

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Job Details

Experience: At least 3 years of coding experience and at least 3 years of education and training experience.

Hold an active RHIA, RHIT, CCS, CCS-P, CPC, or CPC-H credential.
Have at least 3 years of coding experience, including consulting on medical record reviews for large tertiary-care hospitals and outpatient organizations across diverse specialties and primary care.
Have at least 3 years of education and training experience, such as educating coders, providers, or clinical staff.
Demonstrate expert knowledge of ICD-10-CM/PCS, CPT, HCPCS, DRG/MS-DRG, APC, E/M, and NCCI edits.
Have completed an accredited coding, Health Information Management, or Health Information Technician program.
Provide two current client references able to speak to previous audit work, proof of active credentials, and a current resume for the contract proposal.
Demonstrate report-writing, presentation, communication, analytical, and teaching skills, including the ability to explain complex findings in plain language.
Complete required annual VA Privacy and Information Security Awareness and HIPAA training, including TMS 10176 and 10203.
Be able to travel to VA facilities when authorized by the government.
An additional auditing credential such as CDIP, CPMA, or CIC is preferred.
Prior experience auditing for the VA or another federal healthcare system is highly desirable.

Conduct independent external audits of coded inpatient facility/DRG, outpatient facility, inpatient professional, surgery, urgent care, clinic, and ambulatory surgery records.
Review up to the first 25 diagnoses and 25 procedures on each applicable facility and professional services record.
Help develop statistically valid audit samples targeting a 95% confidence level and a minimum of 10% of applicable records, and support data-collection tools.
Review facility-specific HIMS policies and coding procedures before each audit.
Identify and classify coding, diagnosis, modifier, documentation, and compliance errors, and support findings with appropriate coding references.
Prepare facility-level audit reports addressing coding accuracy, financial impact, significant findings, and areas requiring attention; contribute to network-level reporting.
Present draft findings to HIMS leadership, Contracting Officer’s Representatives, and facility leaders, and deliver final reports within 15 business days.
Develop facility-specific education plans and conduct train-the-trainer sessions of at least two hours using real-world charts.
Educate coding professionals, managers, and physicians, and facilitate exit conferences with Health Information Management leadership.
Maintain accurate audit documentation and communicate findings to technical coding audiences and non-coding stakeholders.

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