Healthcare Coding & Audit Consultant

Stout; Tysons (VA); On-site; USD 74,000 - 135,000; Full time

Job summary

Stout is seeking a senior healthcare revenue integrity professional to support complex audits and coding reviews in Tysons, VA. You will evaluate inpatient and outpatient coding accuracy, assess reimbursement methodologies, and develop defensible findings for client deliverables.

The role requires extensive experience across facility and professional coding, strong documentation, and collaboration with legal counsel and client teams. AUS-friendly compensation and benefits are included.

Qualifications

• Bachelor's degree or equivalent work experience in health information or related field.
• 5–10+ years in healthcare coding, billing, auditing, or revenue cycle roles.
• Active credentials such as CCS, CIC, CPC, CPMA, RHIT/RHIA preferred.
• Strong knowledge of coding guidelines, payor policies, CMS requirements, HIPAA, and compliance.

Responsibilities

• Review medical records, claims, and billing data for accuracy and compliance.
• Audit ICD-10-CM/PCS, CPT/HCPCS codes, revenue codes, and modifiers.
• Evaluate reimbursement methodologies (Medicare/Medicaid/commercial) and payer rules.
• Assess medical necessity, level of care, utilization, and documentation alignment.
• Analyze end-to-end revenue cycle, including denials, appeals, and collections.
• Review contracts, coverage policies, and payment determinations.
• Plan and conduct risk-based audits and identify overpayments or underpayments.
• Prepare workpapers, calculations, and defensible findings for reports and testimony.

Skills

Healthcare coding

Billing & auditing

Revenue cycle

Claims operations

Regulatory compliance

Medical record analysis

Communication

Education

Bachelor's degree in Health Information Management, nursing, healthcare administration, business

Job description

Stout is seeking a senior healthcare revenue integrity professional to support complex audits and coding reviews in Tysons, VA. You will evaluate inpatient and outpatient coding accuracy, assess reimbursement methodologies, and develop defensible findings for client deliverables.

The role requires extensive experience across facility and professional coding, strong documentation, and collaboration with legal counsel and client teams. AUS-friendly compensation and benefits are included.