Auditor/Educator Outpatient

Omega Healthcare Management Services; Boca Raton, Northern (FL, KY); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health insurance

401(k) plan with employer match

Paid time off and holidays

Job summary

Omega Healthcare Management Services is seeking an outpatient auditor to review medical records, abstract and code diagnoses and procedures across inpatient, outpatient, ED and pro fee records. The role emphasizes accurate coding for reimbursement, research, and quality evaluation, while maintaining patient confidentiality and regulatory compliance.

Responsibilities include abstracting data, ensuring correct code assignments, and using coding principals to support financial planning and

Qualifications

• Must have completed an AAPC or AHIMA-approved Coding Certificate Program.
• Must hold CPC/COC/CCS/RHIA/RHIT/CCS-P certifications as applicable.
• Requires 2–4 years of current production coding experience in acute care and pro-fee.

Responsibilities

• Abstract, code, sequence and interpret clinical information from multiple records.
• Assign correct principal and secondary diagnoses and procedures with proper sequencing.
• Use coding guidelines and DRG/APC reimbursement rules to assign codes.
• Enter codes into various systems and encoders used by clients.
• Maintain 95% quality rating and ensure HIPAA/compliance adherence.

Skills

Auditing

Medical coding

Epic

Streamline audit tool

ED coding

Education

AAPC/AHIMA coding certificate

RHIA/RHIT/CCS/COC certification

Tools

Epic

Job description

Summary/Objective

Under limited supervision theoutpatient auditor reviews medical records and performsauditing on all diagnoses, procedures, APC and charge codes. The outpatient auditor uses the most accurate codes for reimbursement purposes, research, epidemiology, statistical analysis outcomes, financial and strategic planning, evaluation of quality of care, and communication to support the patient’s treatment. Theoutpatient auditor will be charged with maintaining the confidentiality of patient records and procedures.

Essential Job Functions

Responsible for abstracting, coding, sequencing and interpreting the clinical information from inpatient, outpatient, emergency department, pro fee and clinical medical records.

Responsible for the assignment of correct principal diagnoses, secondary diagnoses and principal procedure and secondary procedure codes with attention to accurate sequencing.

Utilizes technical coding principals and DRG/APC reimbursement expertise to assign appropriate codes.

Abstracts and codes pertinent medical data into multiple software programs and/or encoders. Follows official coding guidelines to review and analyze health records.

Maintains compliance with both external regulatory and accreditation requirements, and with State and Federal regulations.

Extracts pertinent data from the patient’s health record, and determines appropriate coding for reports and billing documents.

Identifies codes for reporting medical services, procedures performed by physicians. Enters codes into various computer systems dependent upon the various clients.

Track and document productivity in specified systems, maintain productivity levels as defined by the client.

Maintain 95% quality rating

Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.

Key Success Indicators/Attributes

Ability to prioritize and multi-task in a fast-paced, changing environment.

Demonstrate ability to work in all work types and specialties.

Demonstrate ability to self-motivate, set goals, and meet deadlines.

Demonstrate leadership, mentoring, and interpersonal skills.

Demonstrate excellent presentation, verbal and written communication skills.

Ability to develop and maintain relationships with key business partners by building personal credibility and trust.

Maintain courteous and professional working relationships with employees at all levels of the organization.

Demonstrate excellent analytical, critical thinking and problem solving skills.

Skill in operating a personal computer and utilizing a variety of software applications.

Knowledge of coding convention and rules established by the AHIMA, American Medical Association (AMA), the American Hospital Association (AHA) and the Center for Medicare and Medicaid (CMS), for assignment of diagnostic and surgical procedural codes.

Knowledge of JCAHO, coding compliance and HIPAA HITECH standards affecting medical records and the impact on reimbursement and accreditation.

Supervisory Responsibility

No

This job operates in a remote home office environment . This role routinely uses standard office equipment such as computers and phones .

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.

Position Type/Expected Hours of Work

This is a full-time position. Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m . This position occasionally requires long hours and weekend work.

Travel

Minimal travel required; up to 5%

Required Education and Experience

Successful completion of an AAPC or AHIMA-approved Coding Certificate Program and a minimum of two to four years of current production coding experience in both acute care and profee .

Preferred Education and Experience

N/A

Additional Eligibility Qualifications

Must have the following certificates and/or licenses: CPC, COC, CIC, RHIA, RHIT, CCS, and/or CCS-P.

Security Access Requirements

In addition to the specific security access required by the employee’s client engagement, the employee will

AAP/EEO Statement

Omega is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Employee may perform other duties as assigned.

Qualifications

Outpatient surgery auditor with at least 2 years of experience auditing outpatient facility surgery encounters all specialties including IVR procedures. Experience with ED coding and leveling is also preferred but not required. Epic experience is required. Experience with PCS coding is strongly preferred. Experience with Streamline audit tool is preferred but not required. A RHIA, RHIT, CCS, or COC certification required.

About Us

Founded in 2003, Omega Healthcare Management Services (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com

We offer a comprehensive benefits package that may include health, dental, and vision coverage, voluntary insurance options, a 401(k) plan with employer match, professional development opportunities, paid time off, and holiday pay. Eligible employees may also have the opportunity to participate in bonus programs, commissions, or other variable incentive plans. Benefits and incentive eligibility may vary based on position, location, and tenure.

AAP/EEO Statement

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.

Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at [e-mail] .

Job Info

• Job Identification 19962
• Region Field Employees - Hourly X4E
• Full-Time/Part-Time Full-Time or Part-Time