Healthcare Audit & Coding Consultant: Impact & Growth

Stout; Baltimore (MD); Hybrid; USD 74,000 - 135,000; Full time

Benefits offered by this job

Total Rewards program

Flexible work schedules

Discretionary time off

Job summary

Stout is seeking a senior healthcare coding and reimbursement expert to lead complex audits and provide actionable guidance across inpatient, outpatient, ASC, and professional fee services.

You will review records, perform audits, and analyze payor policies, ensuring accurate reimbursements and compliance. Collaboration with legal counsel, clinicians, and client teams will be essential for defensible conclusions and client-ready deliverables.

Qualifications

• Bachelor's degree in Health Information Management, nursing, healthcare administration, business, or related field.
• 5-10+ years of progressively responsible experience in healthcare coding, billing, auditing, or revenue cycle.
• Active coding, auditing, billing, or HIM credentials preferred (CCS/CIC/CPC/COC/CPMA etc.).

Responsibilities

• Review medical records, claims, charge detail, billing data, reimbursement data, policies, and contracts for accuracy and compliance.
• Audit ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II and related coding requirements across facilities and professional settings.
• Evaluate reimbursement methodologies (Medicare/Medicaid/commercial) and payer-specific rules.
• Assess clinical documentation, medical necessity, level of care, utilization review, coverage, and code alignment.
• Analyze revenue cycle and claims lifecycle including denials, appeals, and recoupments.
• Review provider contracts and payment determinations across payors.
• Plan and conduct risk-based audits and forensic analyses; identify overpayments/underpayments.
• Develop clear workpapers, findings, and defensible recommendations.

Skills

Coding & Billing

Auditing

Regulatory compliance

Healthcare analytics

Education

Bachelor's degree in HIM/Healthcare Admin

Active coding/billing credentials (CCS/CIC/CPC/CPMA etc.)

Tools

CMS guidelines

Job description

Stout is seeking a senior healthcare coding and reimbursement expert to lead complex audits and provide actionable guidance across inpatient, outpatient, ASC, and professional fee services.

You will review records, perform audits, and analyze payor policies, ensuring accurate reimbursements and compliance. Collaboration with legal counsel, clinicians, and client teams will be essential for defensible conclusions and client-ready deliverables.