Working remotely from anywhere in the U.S., the full-time Outpatient Coding Compliance Auditor will perform audits of outpatient facility coding to ensure compliance with ICD-10-CM diagnoses, CPT/HCPCS codes, and billing standards while effectively communicating findings to stakeholders.
Key responsibilities:
Perform coding compliance and quality audits in support of the Compliance Program and client expectations
Independently analyze clinical documentation from medical records and validate coding accuracy for outpatient facilities
Identify audit findings and calculate billing error rates, providing follow-up validation for corrective action plans
Required qualifications:
Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Outpatient Coder (COC)
5+ years of Outpatient Facility coding experience, including knowledge of NCCI/OCE billing edits
5+ years of Outpatient Facility audit experience, including familiarity with Medicare regulations and OPPS
Proficiency in ICD-10-CM and CPT coding guidelines
Experience with ACEP Facility or similar Facility E/M matrix guidelines for outpatient coding