Physician Coding Auditor

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🔥 2 minutes ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

👻 Ghost score 10%

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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MedKoder, LLC

WebsiteLinkedInAll Job Openings

51 - 200 employees

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

MedKoder, LLC is a full-service medical coding management company specializing in providing expert medical coding services across all physician service lines, including inpatient and outpatient facility coding. The company also focuses on medical risk adjustment management and offers services for clinical documentation improvement, revenue integrity, and revenue cycle consulting. MedKoder utilizes proprietary technology, including Artificial Intelligence, Automated Business Intelligence, and Natural Language Processing, to automate coding processes and improve efficiency. Their customized tools and workflows are built in-house, providing clients with reduced costs and superior results in medical risk adjustment and clinical documentation improvement for Medicare Advantage, ACA, and Medicaid programs.

📋 Description

• Review and accurately code professional multi-specialty services, including evaluation and management, diagnostics, surgeries, and procedures • Perform professional compliance audits of coding and documentation across multiple provider types, specialties, and clients • Apply ICD-10-CM, CPT, AHA Coding Clinics, AMA, CMS, specialty association, and other applicable coding guidelines • Select CPT codes and apply appropriate modifiers • Select and evaluate ICD-10-CM diagnosis codes • Evaluate physician documentation quality and medical necessity • Adhere to LCDs, NCDs, NCCI edits, and payer-specific policies when applicable • Evaluate documentation for split/shared or incident-to services, Teaching Physician Guidelines, FQHCs, RHCs, and HEDIS • Score audits using proper scoring methodology • Identify risk areas and provide mitigation strategies and recommendations • Prepare detailed findings and supporting documentation in customized reports • Prepare and present audit follow-up education to clients • Prepare and present customized education materials remotely and on-site • Communicate with the Physician Audit and Education Manager about issues, trends, and audit timeline completion • Stay current on coding guidelines and maintain credentials • Participate in department and education meetings • Maintain confidentiality and protect sensitive information • Perform other duties assigned by leadership

🎯 Requirements

• High School diploma required • Successful completion of at least one AHIMA or AAPC certification program with the corresponding professional credential (e.g., CCS-P, CPC, or another applicable AAPC stand-alone credential), active and in good standing • Minimum 5 years of recent physician coding experience required • Minimum 3 years of recent physician auditing experience required • Subject matter expert on E&M and Surgical coding • Expert knowledge of medical terminology, anatomy and physiology, disease processes, CPT coding and AMA guidelines, ICD-10-CM coding and guidelines, and Medicare and Medicaid billing policies for professional services • Experience creating and implementing audit plans • Experience educating providers one-on-one or in group settings • Experience working independently, excellent time management, research and organizational skills, ability to switch between multiple projects, and ability to meet project deadlines • Proficiency with Microsoft Word, Excel, PowerPoint, Windows, and healthcare information and billing systems • Associate or BS degree preferred • AAPC CPMA credential preferred but not required • Google Workspace proficiency preferred but not required • Remote work experience preferred but not required • Experience with multiple common EMRs is a plus • Experience specializing in listed profee areas is a plus

🏖️ Benefits

• Flexible schedule • Professional development and education • Permanent positions; no contracts or coding bench • Generous paid time off • Holiday pay • Flexible scheduling year-round • Up to 100% employer-paid medical, dental, and vision benefits for employees • 401K and profit sharing • STD, LTD, life insurance, and FSA program • Paid AAPC and AHIMA corporate memberships • 30 hours of CEU pay (continuance in education) • Internal network of Medical Coding Industry Leaders • National recognition as a Best Place to Work