Medical Coding Auditor, Fully Remote

Role Overview: We are seeking a highly skilled and experienced Medical Coding Auditor to join our team. The ideal candidate will have extensive expertise in both inpatient and outpatient hospital coding and a strong understanding of coding regulations, compliance, and reimbursement methodologies. This role requires at least 5 years of industry experience and involves auditing coded medical records to ensure accuracy, adherence to regulatory guidelines, and optimal reimbursement. The Medical Coding Auditor will also be responsible for providing education and feedback to HIM coding and Revenue Integrity staff and ensuring compliance with federal, state, and payer-specific regulations.  Role Responsibilities: Perform comprehensive coding audits for inpatient and outpatient hospital services, ensuring accuracy and compliance with ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and DRG/APC assignment.  Review medical records, provider documentation, and billing data to identify coding and/or charging errors, inconsistencies, and areas for improvement.  Ensure adherence to CMS (Centers for Medicare & Medicaid Services), OIG (Office of Inspector General), and payer-specific guidelines.  Provide constructive feedback and education to coding and billing staff to improve coding accuracy and compliance.  Collaborate with clinical documentation improvement (CDI) specialists, physicians, and revenue cycle teams to ensure documentation supports coding and billing requirements.  Stay up to date with industry regulations, coding updates, and payer policies, and ensure compliance with evolving standards.  Other duties as assigned Role Requirements: Minimum of 5 years of medical coding experience in both inpatient and outpatient hospital billing.  Experience with hospital-based coding audits, revenue cycle management, and compliance.  Strong knowledge of MS-DRG, APCs, OPPS, and IPPS methodologies.  Experience working with EHR/EMR systems such as Epic, Cerner, or Meditech.  Associate’s or Bachelor’s degree in Health Information Management, Healthcare Administration, or a related field (preferred).  Current coding certificate from AHIMA CCS, CCS-P, CCA or RHIA, RHIT credential or AAPC certifications including CPC, CIC, COC. Credentials are required to be maintained during employment.   Additional credentials such as CDIP, CRCR, CRCA or CPMA are a plus. Proficiency in ICD-10-CM, ICD-10-PCS, CPT, HCPCS, DRG, and APC classification systems.  Thorough understanding of Medicare, Medicaid, and commercial payer regulations.  Familiarity with NCCI edits, LCD/NCD policies, and medical necessity guidelines.  Experience with coding compliance audits.  Strong analytical, research, and problem-solving skills.  #indeed3

Salary : $34 - $41