Senior Consultant – Profee Auditor, Quality and Education

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🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟠 Senior

🔎 Auditor

👻 Ghost score 15%

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Cognate Fractional Talent Acquisition

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🤝 B2B

Recruitment • B2B

Cognate Fractional Talent Acquisition is a firm that provides in-house recruitment capabilities on a fractional basis, positioning in-house recruiting as a competitive advantage for client companies. They offer expertise and resources to serve businesses that need internal recruiting support without hiring full-time recruitment teams, aligning with the Staffing and Recruiting focus listed on their LinkedIn profile.

📋 Description

• Perform coding audits on a variety of professional fee medical records • Utilize and enhance professional fee auditing and coding skills • Independently research complex coding scenarios and support audit findings with coding and regulatory references • Translate audit findings and trends into clear, actionable education • Provide individualized feedback and one-on-one coaching to internal coders and auditors • Participate in peer review, audit-the-auditor, calibration, and other quality assurance activities • Communicate audit findings, coding rationale, education, and constructive feedback to coders, auditors, and leadership • Manage multiple assignments and deadlines in a fast-paced, quality-driven environment • Finalize and present impartial, objective audit findings • Work from home while adapting to changing priorities

🎯 Requirements

• Active AHIMA or AAPC certification, i.e., CPC, CPMA, CCS-P, or COC • Minimum of 3-5 years of hands-on professional fee coding and medical record auditing in a multi-specialty or hospital-affiliated setting • Experience across multiple medical specialties, including Emergency Department, Hospitalist, Primary Care, ENT, Nephrology, Urology, Cardiology, Thoracic, Neurology, Obstetrics and Gynecology, Behavioral Health, Ophthalmology, Endocrinology, etc. • Advanced knowledge and demonstrated auditing experience across the full range of professional coding, including ICD-10-CM diagnosis coding, CPT, HCPCS, modifiers, E/M leveling, and procedural coding • Strong knowledge of professional coding guidelines, CPT guidelines and conventions, CMS regulatory requirements, NCCI edits, and other applicable profee coding and billing requirements • Ability to independently research complex coding scenarios and interpret authoritative coding guidance, including Official Coding Guidelines, Medicare/Medicaid Claims Processing Manual, OIG guidance, LCD/NCD documents and transmittals • Ability to translate audit findings and identified trends into clear, actionable education and provide individualized feedback and one-on-one coaching • Experience participating in or supporting peer review, audit-the-auditor, calibration, and other quality assurance activities • Strong computer skills, including familiarity with EHR systems such as EPIC and Cerner, automated auditing tools, and secure file transfer in compliance with HIPAA policies • Excellent verbal and written communication skills • Strong organizational and time-management skills; ability to prioritize competing responsibilities, meet deadlines, and maintain quality and productivity standards • Ability to remain impartial and objective in finalizing and presenting audit findings

🏖️ Benefits

• Medical, Dental, Vision and Life Insurance • Short/ long-term disability • PTO • 401(K) • Referral bonuses • Training opportunities • Yearly educational allowances • Continuing education programs • Dedicated support team for guidance and mentoring • Birthday recognition • Holiday gift selections • Years of service awards • Quality bonus programs • Career growth and development • Dynamic work environment

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