Revenue Cycle Managed Services Coding Auditor

<h3>Accountabilities</h3><li>
<strong>Coding Audits and Quality Assurance:</strong>Conduct routine, focused, and validation audits of professional medical coding across multiple specialties to assess coding accuracy, documentation support, compliance, and reimbursement impact.</li><li>
<strong>Compliance and Regulatory Standards:</strong>Ensure coding practices align with ICD-10-CM, CPT, HCPCS, payer-specific guidelines, and applicable regulatory requirements.</li><li>
<strong>Root Cause Analysis and Reporting:</strong>Investigate coding errors and recurring discrepancies, track audit results and quality metrics, identify performance trends, and escalate significant issues to the appropriate leadership.</li><li>
<strong>Coder Education and Development:</strong>Provide actionable audit feedback, mentor coding staff, and develop and deliver individual or group training sessions based on identified knowledge gaps and quality trends.</li><li>
<strong>Training Materials and Onboarding:</strong>Create educational resources, reference guides, and coding documentation while supporting the onboarding, training, and ongoing professional development of coding team members.</li><li>
<strong>Client Support and Coding Expertise:</strong>Serve as a coding subject matter expert for assigned clients, participate in client meetings, research complex coding scenarios, and communicate recommendations on documentation, coding, and compliance.</li><li>
<strong>Policy Development:</strong>Support leadership in developing, reviewing, and implementing coding policies, procedures, and best practices.</li><li>
<strong>Production Coding Support:</strong>Assist with coding production during periods of high volume, staffing shortages, or other operational needs while maintaining established productivity and accuracy standards.</li><li>
<strong>Denial Management and Revenue Cycle Optimization:</strong>Review coding-related denials, identify opportunities for appeals or corrections, and collaborate with coding, revenue cycle, and operations teams to reduce recurring denial patterns.</li><li>
<strong>Payer Audits and Documentation Reviews:</strong>Support payer audit responses, review supporting medical documentation, and recommend corrective actions to strengthen compliance and reimbursement outcomes.</li><li>
<strong>Continuous Improvement:</strong>Monitor coding regulations, industry developments, and payer policy changes; participate in internal and external audits; and recommend process improvements that enhance quality, efficiency, and compliance.</li><li>
<strong>Special Projects and Collaboration:</strong>Contribute to client initiatives, operational projects, and other assignments while managing multiple priorities independently and effectively.</li><h2>Requirements</h2><li>
<strong>Professional Experience:</strong>Three to five years of medical coding auditing experience, with demonstrated expertise in evaluating coding accuracy, reviewing documentation, and delivering constructive audit feedback.</li><li>
<strong>Medical Coding Knowledge:</strong>Strong working knowledge of CPT, ICD-10-CM, HCPCS, payer-specific coding guidelines, and applicable compliance requirements.</li><li>
<strong>Documentation Review:</strong>Proven ability to interpret clinical documentation, apply appropriate coding principles, identify discrepancies, and assess the potential impact on reimbursement.</li><li>
<strong>Audit and Analytical Skills:</strong>Experience conducting coding audits, performing root cause analysis, interpreting quality metrics, and identifying opportunities for process improvement.</li><li>
<strong>Communication Skills:</strong>Excellent written and verbal communication skills, including the ability to explain complex coding issues clearly and provide actionable feedback to coding professionals, clients, and internal stakeholders.</li><li>
<strong>Education and Mentorship:</strong>Ability to coach and mentor coding staff, develop educational materials, deliver training, and support ongoing performance improvement.</li><li>
<strong>Organizational Skills:</strong>Strong analytical, organizational, and problem-solving abilities, with the capacity to work independently, prioritize competing demands, and meet quality and productivity expectations.</li><li>
<strong>Preferred Specialty Experience:</strong>Experience auditing surgical specialties such as obstetrics and gynecology (OB/GYN), orthopedics, and urology. Evaluation and management (E/M) auditing experience is also advantageous.</li><li>
<strong>Preferred Certifications:</strong>Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Coding Specialist–Physician-based (CCS-P), or an equivalent medical coding certification.</li><li>
<strong>Preferred Technical Experience:</strong>Familiarity with Epic electronic medical records (EMR) systems and professional or physician-fee coding workflows.</li><li>
<strong>Client-Facing Experience:</strong>Previous experience working directly with healthcare clients and communicating coding recommendations or compliance findings.</li><li>
<strong>Revenue Cycle Knowledge:</strong>Understanding of denial management, claims appeals, reimbursement processes, and strategies for reducing coding-related denials.</li><li>
<strong>Training Experience:</strong>Experience developing coding education programs, training resources, and structured feedback processes.</li><li>
<strong>Work Arrangement:</strong>Ability to work remotely within the United States and maintain a flexible schedule aligned with client and project requirements.</li><h2>Benefits</h2><li>
<strong>Remote Work:</strong>Remote-friendly position offering the flexibility to work from home.</li><li>
<strong>Flexible Scheduling:</strong>Scheduling flexibility based on project requirements and operational needs.</li><li>
<strong>Compensation:</strong>Hourly, non-exempt position. Compensation details are determined based on relevant skills, experience, training, certifications, and organizational requirements. A specific hourly pay range was not provided in the original posting.</li><li>
<strong>Potential Performance Bonus:</strong>Annual performance bonuses may be available for eligible salaried positions; eligibility for this hourly role is not specified.</li><li>
<strong>Additional Benefits and Perks:</strong>Other benefits and perks may be available depending on the position and employment terms; specific healthcare, retirement, and paid leave details were not provided.</li><li>
<strong>Professional Development:</strong>Opportunities to expand coding expertise, participate in training initiatives, and contribute to continuous quality improvement.</li><li>
<strong>Collaborative Environment:</strong>Work alongside experienced coding professionals, healthcare consultants, and revenue cycle specialists.</li><li>
<strong>Meaningful Healthcare Impact:</strong>Help healthcare organizations improve coding quality, strengthen compliance, reduce denials, and support more effective financial and operational performance.</li><li>
<strong>Inclusive Culture:</strong>Join a professional environment that emphasizes collaboration, integrity, autonomy, diverse perspectives, and employee development.</li>