Medical Coder – Audit Specialist

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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 and related documentation for coding accuracy and compliance with Indiana Health Coverage Programs, CMS, AMA, and applicable standards and regulations • Conduct coding and documentation reviews independently and provide preliminary findings to the Lead Reviewer • Identify coding discrepancies, documentation deficiencies, and billing compliance issues • Maintain detailed workpapers documenting procedures, records reviewed, findings, and conclusions • Assist with audit responses and appeals • Align work with state, federal, and national coding and reimbursement guidelines • Stay current on CPT, HCPCS, ICD-10-CM, Medicaid coding guidelines, policies, and regulatory updates • Research Indiana Medicaid rules and maintain repositories of bulletins, policies, and procedures • Adapt to changing priorities, policies, regulatory updates, and review requirements while maintaining accuracy and meeting deadlines

🎯 Requirements

• Coding certification such as CCS, CPC, or CPMA required • At least 1 year of medical coding, claims review, billing compliance, or related healthcare reimbursement experience • Familiarity with Indiana Medicaid policies, payer guidelines, and documentation requirements preferred • Candidate located in or near the Indianapolis area preferred • Proficiency in Microsoft Excel, Word, and Outlook • Strong analytical, critical thinking, problem-solving, and technical writing skills • Ability to work independently and collaboratively in a fast-paced environment • Experience working with healthcare providers strongly preferred • Knowledge of healthcare claims data and fraud, waste, and abuse preferred • Ability to talk or hear, sit, and use technology tools such as a laptop for extended periods • Close vision and ability to adjust focus • Ability to meet the essential physical demands of the role, with reasonable accommodations available