Coding Auditor

Job not on LinkedIn

🔥 6 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

👻 Ghost score 10%

What it means: the chance that no one is really hiring for this job.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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📋 Description

• Evaluate and improve the quality, accuracy, compliance, and consistency of coding performed by internal and outsourced coding vendors across ASC, Professional Fee, Hospital Outpatient, and future coding programs • Perform routine and targeted audits of internal and outsourced coding vendors • Conduct pre-bill, post-bill, focused, and retrospective audits • Evaluate coding accuracy, modifier usage, sequencing, documentation support, and compliance • Review ICD-10-CM, ICD-10-PCS, CPT, HCPCS, CMS, NCCI, payer policies, and organizational standards • Validate documentation and medical necessity • Monitor coding quality and trends • Assist with scorecards and corrective action plans • Support internal/external audits and regulatory compliance • Provide coder education and feedback • Partner with Revenue Integrity, HIM, Compliance, CDI, and Operations • Prepare audit reports, dashboards, and trend analyses • Recommend process improvements and maintain coding policies • Serve as coding subject matter expert and provide audit feedback and education under the direction of the Coding Vendor Manager • Support facility and vendor meetings, audits, and organizational initiatives

🎯 Requirements

• Advanced knowledge of ICD-10-CM/PCS, CPT, HCPCS, CMS, NCCI, ASC, Hospital Outpatient, and Professional Fee coding • Strong analytical, communication, auditing, and documentation review skills • Experience with encoder systems, EHRs, auditing software, Excel, and Microsoft Office • Bachelor's degree preferred or equivalent experience • Minimum 5 years coding experience • Minimum 3 years coding audit experience • Experience auditing ASC, Hospital Outpatient, and Professional Fee coding • Vendor auditing experience preferred • Preferred certifications: CCS, CPC, CCS-P, RHIA, and/or RHIT • CPMA a plus • Ability to comply with applicable coding standards, payer requirements, and regulatory guidelines • Successful completion of pre-employment screening, including criminal background checks and drug testing

🏖️ Benefits

• Reasonable accommodations for applicants with disabilities • Occasional travel supporting facility and vendor meetings, audits, and organizational initiatives • Equal opportunity employment and workforce diversity commitment • Pre-employment screening including criminal background checks and drug testing

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