Medical Coder, Audit Specialist

🔥 55 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🏥 Medical Billing and Coding

👻 Ghost score 12%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Briljent

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 1998

💼 Consulting

🏥 Healthcare

🏛️ Government

Consulting • Healthcare • Government

Briljent is a consulting and professional services firm that helps organizations bridge the gap between strategy and execution by focusing on people and performance. Since 1998, Briljent has delivered training, organizational change management, project and program management (PMO), health strategy and innovation, staffing services, and integrated solutions that combine consulting, project delivery, and workforce augmentation. They work with government (state and federal), healthcare and human services, education, and private sector clients (including Fortune 500 companies) to support technology implementations, compliance initiatives, workforce readiness, and complex transformations. Briljent emphasizes instructional design, certified change practitioners, PMPs, former healthcare policy and Medicaid leaders, and a proven recruiting process to deliver measurable outcomes such as increased adoption, reduced risk, and sustainable organizational change.

📋 Description

• Review medical records, claims, and supporting documentation to evaluate coding accuracy and compliance with Indiana Health Coverage Programs, CMS, AMA, and other applicable regulations • Perform detailed coding audits and documentation reviews independently • Identify coding discrepancies, documentation deficiencies, billing irregularities, and potential compliance concerns • Maintain thorough audit workpapers documenting procedures, records reviewed, findings, and conclusions • Present preliminary findings and recommendations to audit leadership • Use Microsoft Excel to organize, analyze, and validate audit results and claims data • Prepare audit reports, summaries, and supporting documentation for internal and external stakeholders • Identify patterns and trends indicating billing errors, documentation concerns, or process improvement opportunities • Support appeal reviews and audit response activities • Research and interpret Indiana Medicaid policies, bulletins, and reimbursement requirements • Maintain internal repositories of coding guidance, regulatory updates, and audit resources • Stay current on CPT, HCPCS, ICD-10-CM, Medicaid coding guidance, and reimbursement methodologies • Adapt to changing regulations, priorities, and audit requirements while maintaining accuracy and quality • Occasional travel within Indiana

🎯 Requirements

• Current coding certification such as CCS, CPC, CPMA, or equivalent • Minimum of one (1) year of experience in medical coding, coding audits, billing compliance, claims review, healthcare reimbursement, or related auditing activities • Strong proficiency in Microsoft Excel, including data analysis, sorting/filtering, formulas, data validation, reporting, and working with large datasets • Strong analytical thinking, problem-solving, and technical writing skills • Ability to work independently while managing multiple priorities in a fast-paced environment • Regularly able to talk or hear, sit, and utilize technology tools such as a laptop computer for extended periods • Close vision and ability to adjust focus

🏖️ Benefits

• Meaningful impact on healthcare programs serving Hoosiers • Work alongside experienced healthcare, compliance, and auditing professionals • Ongoing engagement with evolving coding standards, regulations, and industry best practices