Remote Medical Coding Auditor

Description

Required: 3-5 experience in acute care facility (hospital) medical coding auditing or compliance

Location: 

Remote

Job Summary:

The Medical Coding Auditor is responsible for reviewing medical records to ensure accurate coding and compliance with regulatory requirements. This role ensures continuous quality improvement in coding practices while maintaining compliance with healthcare laws and organizational policies. Occasional travel may be required for audits or meetings. 

Key Responsibilities:

· Conduct reviews and audits of medical records for coding accuracy (ICD-10-CM, CPT, HCPCS) and documentation compliance. 

· Ensure compliance with federal, state, and payer-specific regulations, including CMS guidelines. 

· Identify and address coding discrepancies and recommend corrective actions. 

· Prepare detailed audit reports with findings and provide feedback on documentation and coding practices. 

· Collaborate with relevant departments to resolve audit findings and ensure ongoing compliance with policies and regulations. 

· Stay current with changes in coding guidelines, healthcare regulations, and payer policies. 

· Assist in developing and refining audit tools, policies, and procedures to support continuous improvement. 

· Monitor and track corrective actions post-audit and ensure follow-up to resolve identified issues. 

· Ensure abstracted data impacting reimbursement is accurate: discharge disposition, admission source, POA (present on admission) indicators, procedure dates of service, etc. 

· Adhere to facility's coding guidelines and coding policy and procedures, as needed. 

Requirements

Education:

· Associate's Degree in Health Information Management or related field.

· Bachelor’s Degree in Health Information Management, Nursing, or a related field is a plus.

· Or equivalent combination of education and relevant experience.

Certification:

· Registered Health Information Administrator (RHIA)
· Registered Health Information Technician (RHIT)
· Certified Coding Specialist (CCS)
· Certified Coding Associate (CCA)
· Certified Outpatient Coder (COC)
· Certified Inpatient Coder (CIC)
· Certified Professional Coder (CPC)

· Registered Health Information Administrator (RHIA)

Experience:

· 3-5 years of relevant experience in acute care facility (hospital) medical coding, auditing, or compliance roles.

Skills:

· Expertise in medical coding systems (ICD-10-CM, CPT, HCPCS), healthcare billing, and medical terminology.

· Familiarity with CMS regulations, payer requirements, and healthcare compliance laws.

· Excellent analytical skills with a strong attention to detail.

· Effective communication skills for education and collaboration.

· Proficiency in using healthcare software and EHR systems (e.g., Epic, Cerner).

Working Conditions:

· Remote work with flexibility to manage tasks independently.

· Occasional travel may be required for training sessions or audits.