IVR OP Auditor - PB/HB - PRN

e4health; Pittsburgh (Allegheny County); Remote; USD 34,000 - 55,000; Part time

Benefits offered by this job

401(k) with company match

Medical insurance

Dental insurance

Vision insurance

Life insurance

PTO policy

Job summary

e4health is seeking an Outpatient Auditor for a remote, PRN role up to 20 hours per week. The auditor will perform quality assurance reviews of outpatient coding for various facilities, ensuring ICD-10-CM, CPT, HCPCS compliance and accurate data abstraction.

Responsibilities include monitoring accuracy rates above 95%, training and onboarding new coders, and reporting quality metrics to management. Remote work from home with flexible scheduling and competitive benefits.

Qualifications

• Minimum 4 years’ coding experience.
• Minimum 4 years auditing experience.
• AHIMA or AAPC credential required (CIRCC/RCCIR a plus).
• At least 2 years of remote work experience preferred.

Responsibilities

• Perform quality assurance reviews for outpatient coding accuracy.
• Audit onboarding and training of new coding consultants.
• Provide education on error trends and quality improvements.
• Maintain productivity and accuracy targets (≥95%).
• Communicate quality issues to management as needed.

Skills

Coding experience

Auditing experience

Remote work experience

Education

AHIMA or AAPC credential

Tools

PB IVR auditing

HB IVR auditing

Job description

About e4health

At E4health, Our Vision Is To Empower Better Health For Our Clients, Our Team, And The Communities We Serve. We Live By Five Core Values That Guide Everything We Do

• Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth.
• Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day.
• WE GROW: We believe in win/win outcomes—when our customers win, we win.
• GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions.
• Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully.

Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our solutions streamline clinical, financial, and health information workflows, optimize coding, quality, and clinical documentation integrity processes, and address health IT operational challenges to deliver material results for healthcare organizations across the country. Learn more about us at www.e4.health.

Position Title

Outpatient Auditor

Role Type

PRN up to 20 hours per week

Employment Type

Non-Exempt

Job Summary

The Outpatient Auditor is responsible for completing quality assurance reviews on internal and/or external outpatient coding specialists or external providers. The facility-based chart types may include one or more of the following: Emergency Department, Observation, Same Day Surgery, Ancillary, Interventional Radiology, or Facility-Based Clinic. This may also include onboarding audits and training of newly hired e4health coding specialists. This role is responsible for validating the coding specialist is accurately for accurately abstracting data into appropriate client electronic medical record systems, following the Official ICD-10-CM, CPT, and HCPCS Guidelines for Coding, AMA CPT Guidelines, and CMS directives. The Outpatient Auditor also plays a key role in reporting quality results, tracking and trending of educational opportunities of the coding specialist, responding to client subject matter needs, and providing educational support and training to coders and/or providers. The Outpatient Auditor is expected to maintain consistent coding auditing accuracy rate of 95% or better while also meeting agreed upon productivity standards.

Essential Duties And Responsibilities

• Complete all regularly scheduled quality assurance reviews for clients
• Complete onboarding quality assurance reviews for newly hired consultants
• May provide training for newly hired coding consultants
• Communicate quality issues to management as appropriate
• Assist with identification of, drafting, implementation, and monitoring of quality improvement action plans for coding consultants
• Maintain reports and accuracy rates for coding consultants and clients as appropriate.
• Respond to client QA needs at the direction of management
• Provide coding consultants educational sessions on error trends as requested by management
• Notifying management when there is a compliance concern or incident
• Demonstrating knowledge of HIPAA Privacy and Security Regulations as evidenced by appropriate handling of patient information
• Promoting confidentiality and using discretion when handling patient information.
• Attend educational conference calls
• Provide coding support to the business as needed
• Perform other duties as needed with the project
• Maintains required productivity and quality requirements
• Maintains coding credential requirements

Benefits

We offer an excellent salary, full benefits package including 401(k) with company match, medical, dental, vision, life, short/long term disability insurance, and PTO policy.

Physical Demands Of The Essential Functions

• This role requires prolonged periods of desk working on a computer
• Talking, hearing, and near vision are required to perform computer-based tasks and virtual communication
• Sensory perception (visual, auditory, and tactile) is essential for computer and phone use

Working Conditions While Performing Essential Functions

This is a remote role; work is performed in a home office environment.

e4health is an equal opportunity employer and will consider all applications without regard to race, color, religion, national origin, ancestry, marital status, veteran status, age, disability, pregnancy, genetic information, gender, sexual orientation, gender identity or any other legally protected category.

Applicants for U.S. based positions with e4health must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Visa sponsorship is not available for this position.

Requirements

REQUIRED QUALIFICATIONS

• Candidate must possess an approved AHIMA or AAPC coding credential; CIRCC/RCCIR a plus
• Minimum 4 years’ coding experience
• Minimum 4 years auditing experience
• Experience with both professional fee (PB) and facility (HB) IVR auditing is required
• Recommend at least 2 years of remote experience

Key Success Attributes

• Integrity, passion, and ethics are required
• Demonstrates strong collaboration skills
• Has strong analytic and problem-solving abilities and techniques
• Exhibit consistent initiative with strong drive for results and success
• Demonstrate commitment to a team environment?
• Well-developed written, verbal, and presentation communication skills including deep listening and attention to detail
• Ability to self-motivate and self-direct
• Possess strong time management and organizational skills
• Commitment and adherence to company Core Values

Core Competencies

• High level of integrity & ethical judgement
• Communication
• Consistency and Reliability
• Meeting Standards