Healthcare Coding & Audit Consultant — Flexible Schedule

Stout; Chicago (IL); On-site; USD 74,000 - 135,000; Full time

Benefits offered by this job

Total rewards program

Flexible work schedules

Discretionary time off

Career growth & mentorship

Job summary

Stout is seeking a seasoned healthcare audits professional to join our team in Chicago. You will review records and contracts, audit ICD-10-CM/PCS, CPT, and revenue codes, and evaluate reimbursement across Medicare, Medicaid, and commercial payors.

You will plan and conduct risk-based audits, document methodologies, and present clear findings to clients. This role emphasizes collaboration with clinical and legal teams and adherence to healthcare compliance standards.

Qualifications

• Bachelor’s degree in Health Information Management, nursing, healthcare administration, business, or related field.
• 5–10+ years of healthcare coding, billing, auditing, reimbursement, or claims operations experience.
• Hands-on experience with inpatient facility, outpatient facility, ASC, and professional fee coding/billing.
• Active coding, auditing, billing, or HIM credentials preferred (e.g., CCS, CIC, CPC, RHIT, RHIA).
• Knowledge of coding guidelines, CMS requirements, HIPAA, and healthcare compliance.
• Experience as HIM leadership or contracts/claims risk preferred.

Responsibilities

• Review records, claims, policies, and contracts for accuracy and compliance.
• Audit ICD-10-CM/PCS, CPT, HCPCS Level II, modifiers, units, and revenue codes.
• Evaluate reimbursement methodologies across Medicare, Medicaid, and payors.
• Assess documentation, medical necessity, level of care, and utilization.
• Analyze revenue cycle from charge capture to collections, including denials and appeals.
• Review provider contracts and payment determinations.
• Plan risk-based audits and identify overpayments or underpayments.
• Prepare workpapers, findings, and defensible recommendations.
• Prepare client-ready deliverables and support regulatory responses or expert reports.
• Collaborate with clients, counsel, clinicians, and billing teams; provide guidance on audit practice.

Job description

Stout is seeking a seasoned healthcare audits professional to join our team in Chicago. You will review records and contracts, audit ICD-10-CM/PCS, CPT, and revenue codes, and evaluate reimbursement across Medicare, Medicaid, and commercial payors.

You will plan and conduct risk-based audits, document methodologies, and present clear findings to clients. This role emphasizes collaboration with clinical and legal teams and adherence to healthcare compliance standards.