Senior Outpatient Coding Auditor – Provider Education Specialist

🕒 May 11

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EXL

WebsiteLinkedInAll Job Openings

10,000+ employees

💰 $2M Venture Round on 2015-01

Choosing a digital partner is about more than capabilities — it’s about collaboration and character.

📋 Description

• Conduct one-on-one and group education sessions with providers to explain observed billing trends, coding requirements and best practices. • Reinforce appropriate documentation standards to support accurate code selection and reimbursement. • Translate complex coding and reimbursement guidelines into clear, practical guidance tailored to provider workflows. • Perform detailed audits of outpatient medical records to assess accuracy of CPT, HCPCS, and ICD-10 coding, as well as compliance with payer policies and regulatory requirements. • Identify patterns of coding variation, documentation deficiencies, and potential compliance risks.

🎯 Requirements

• Bachelor’s degree in Health Information Management, Healthcare Administration, or related field (or equivalent experience). • Minimum of 5+ years of outpatient coding, auditing, or compliance experience. • Active certification such as AAPC (e.g., CPC, CPMA) or AHIMA (e.g., CCS, CCS-P, RHIT, RHIA). • Extensive knowledge of CPT, HCPCS, and ICD-10 coding systems, as well as CMS and payer reimbursement methodologies. • Demonstrated experience auditing E/M services and other outpatient procedures. • Preferred Qualifications: Experience in provider education or clinical documentation improvement (CDI). • Experience working directly with physicians, advanced practice providers, and behavioral health clinicians. • Background in healthcare analytics or performance improvement initiatives.

🏖️ Benefits

• Health insurance • Vision • Dental • 401(k) options • Mentorship and career development programs • Fast-paced, innovative environment