Professional Fee Coding Auditor

Job not on LinkedIn

🔥 7 minutes 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 professional-fee coding for accuracy, documentation support, compliance, and reimbursement impact • Evaluate ICD-10-CM, CPT, HCPCS Level II, evaluation and management, modifier, professional-component, and bundling assignments • Verify provider information, scope of practice, billability, and documentation support for reported professional services • Identify incorrect, missing, unbundled, upcoded, downcoded, unsupported, or otherwise noncompliant codes and modifiers • Review diagnoses and procedures in the electronic health record 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 designated facility personnel • Prepare or support final reports addressing accuracy, documentation issues, financial impact, process improvement, and educational needs • Develop and deliver facility-specific coding education and support exit conferences • Protect VA information and follow privacy, information-security, encryption, and remote-work requirements • Meet assigned audit schedules, reporting deadlines, training requirements, credential requirements, and access requirements

🎯 Requirements

• U.S. citizenship • Ability to read, write, speak, and understand English • 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 • Completion of required VA privacy, information-security, and mandatory training • Ability to work securely within the United States • Ability to maintain audit accuracy of at least 95 percent • Ability to meet reporting and turnaround requirements • Current resume documenting required coding, consultant record-review, and education or training experience • Signed Letter of Intent and completed candidate cover page • Proof of an active accepted AHIMA or AAPC credential • Two current client references specific to the individual reviewer • OIG exclusion search results and requested background, security, identification, privacy, training, or onboarding documents

🏖️ Benefits

• Competitive salaries and benefits packages • Fully remote work arrangement within the United States • Remote schedules aligned with assignment requirements • Approved equipment, software, encoder tools, internet connectivity, reference resources, and secure workspace for remote work