Medical Record Audit Specialist

🕒 August 20

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 24%

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RADcube

WebsiteLinkedInAll Job Openings

201 - 500 employees

💼 Consulting

🏥 Healthcare

📦 Logistics

Consulting • Healthcare • Logistics

<RADcube> is a global technology and systems integration partner that designs and delivers production-ready AI platforms through RADlabs, focusing on governed, secure, and enterprise-scale solutions. The company builds governed AI and agentic systems, intelligent document processing (HIPAA-aware), data engineering and analytics, cloud & DevOps, cybersecurity & GRC, and process automation to modernize systems, operationalize AI, and scale innovation with an emphasis on security, compliance, and Responsible AI. RADcube serves multiple industries including government, health & life sciences, banking & finance, e-commerce, manufacturing, transportation & logistics, and education.

📋 Description

• Review medical records and related documentation to assess coding accuracy and compliance with Indiana Health Coverage Programs, CMS, AMA, and other applicable standards and regulations • Conduct coding and documentation reviews independently and provide preliminary findings to the Lead Reviewer • Identify potential coding discrepancies, documentation deficiencies, and billing compliance issues • Maintain detailed work-papers documenting procedures performed, records reviewed, findings identified, and conclusions reached • Assist with audit responses and appeals as needed • Ensure all work aligns with state, federal, and national coding and reimbursement guidelines • Stay current on CPT, HCPCS, ICD-10-CM, and Medicaid coding guidelines, policies, and regulatory updates • Research Indiana Medicaid rules and maintain internal repositories of bulletins, policies, and procedures • Adapt to changing priorities, policies, regulatory updates, and review requirements while maintaining accuracy and meeting deadlines • Support a state Medicaid program engagement focused on medical record and claims auditing

🎯 Requirements

• Active coding certification: CCS (AHIMA), CPC (AAPC), or CPMA (AAPC) • Minimum 2-3 years of hands-on medical coding, claims review, or audit experience • Significant experience coding Behavioral Health, Mental Health, or Psychiatric encounters • Hands-on proficiency with ICD-10-CM, CPT, and HCPCS coding systems • Experience conducting medical record audits, claims reviews, or supporting appeals • Comfortable completing a timed Excel proficiency assessment covering sorting, filtering, VLOOKUP, and conditional formatting, required by the client prior to submission • Familiarity with Indiana Medicaid (IHCP) policies and payer guidelines preferred • Knowledge of CMS regulations and AHIMA Standards of Ethical Coding preferred • Experience with Epic, Cerner, 3M Encoder, or similar EHR and encoder platforms preferred • Prior experience specifically supporting Medicaid audit or compliance functions preferred

🏖️ Benefits

• Occasional travel to Downtown Indianapolis, IN with expenses covered

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