Inpatient/Outpatient Coding Auditor

Job not on LinkedIn

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $38 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

👻 Ghost score 0%

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Fidelity Partners Services

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2002

🏥 Healthcare

📦 Logistics

🏛️ Government

Healthcare • Logistics • Government

Fidelity Partners Services is a national provider with over 30 years of experience delivering healthcare, technology, logistics, and ancillary services to government and commercial clients. The company emphasizes integrity, hands-on contract management, strong customer service, and mission-focused support across government and commercial engagements.

📋 Description

• Independently audit inpatient and outpatient facility coding for accuracy, documentation support, compliance, and reimbursement impact • Evaluate ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, evaluation and management, modifier, bundling, present-on-admission, procedure, and DRG assignments • Review inpatient hospitalizations and outpatient clinic, urgent-care, radiology, laboratory, ancillary, observation, and ambulatory surgical encounters • Assess diagnoses, procedure coding, documentation sufficiency, billability, and coding guidance • Identify incorrect, missing, duplicate, unbundled, unsupported, upcoded, downcoded, or noncompliant codes, modifiers, and data elements • Review electronic health record documentation and approved audit tools using established sampling requirements • Document findings with supporting authority, financial impact, risk, and recommended corrective action • Maintain audit accuracy of at least 95 percent and participate in calibration processes • Contribute to audit work plans, collection tools, facility reports, consolidated reports, and progress updates • Review preliminary findings with HIMS leadership, the COR, management, and facility personnel • Prepare or support final reports on accuracy, documentation issues, financial impact, process improvement, and educational needs • Develop and deliver facility-specific coding education, support exit conferences, and explain findings using authoritative guidance • Protect VA information and meet audit schedules, reporting deadlines, training, credential, and access requirements

🎯 Requirements

• U.S. citizenship and English-language proficiency • Active RHIA, RHIT, CCS, CCS-P, CPC, or CPC-H credential • At least two years of coding experience in the applicable coding area • At least three years of consultant experience reviewing records in large tertiary-care hospitals and outpatient organizations with primary care and subspecialty services • At least three years of education and training experience • Proficiency with ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, DRG, modifier, bundling, reimbursement, documentation, and compliance requirements • Successful completion of the Low Risk NACI background process and required VA privacy, information-security, and mandatory training • Ability to work securely within the United States • Minimum audit accuracy of 95 percent • Ability to meet reporting and turnaround requirements • Current resume, signed Letter of Intent, completed candidate cover page, proof of active accepted AHIMA or AAPC credential, and two current client references • OIG exclusion search results and any requested background, security, identification, privacy, training, or onboarding documents

🏖️ Benefits

• Competitive salaries and benefits packages