Profee Audit Specialist - FT

Datavant; Northern (KY); Hybrid; USD 70,000 - 110,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401k with match

Paid time off

Paid holidays

CEUs

Education stipend

Equipment provided

Training and mentorship

Sign-on bonus

Job summary

Datavant is hiring a Profee Audit Specialist (full-time) to perform Professional Fee coding audits across medical records using ICD-10-CM, CPT, HCPCS, and modifiers. This fully remote role supports education and compliance initiatives within healthcare coding workflows.

The ideal candidate has 5+ years of professional fee coding and auditing experience, CPC certification, and strong attention to accuracy. Join a mission-driven team advancing healthcare data interoperability from your home office.

Qualifications

• 5+ years of Professional Fee coding and/or auditing.
• CPC certification required.
• Experience with Epic/Cerner and EMRs.

Responsibilities

• Performs Professional Fee coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and modifiers.
• Provides rationale with references and documentation locations for changes.
• Keeps abreast of regulatory changes.
• Organizes and prioritizes multiple cases concurrently.
• Provides coder education through the auditing process.
• Functions professionally, efficiently, and positively.
• Adheres to AHIMA's code of ethics.
• Demonstrates customer-service focus and professionalism.
• Exhibits high-level organizational, teamwork, and leadership skills.

Skills

Professional Fee coding

Education

CPC (required)

CPMA (preferred)

Tools

Epic

Cerner

Job description

Profee Audit Specialist - FT

8268 Remote - United States Full-time regular

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health.
By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare.

************ Currently offering 2,500 Sign on Bonus!!!!! ************* What We’re Looking For:

As a Profee Auditing Specialist,you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. In this role, you will offer meaningful information tailored to exceed customer expectations, actively identifying and presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace!

********Preferred: A candidate that has worked with multi-specialties. Prefer a candidate with availability within normal business hours, prefer 20 hours/week.********* What You Will Do:

• Performs Professional Fee coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and modifiers and appropriate coding references for accurate coding assignment.
• Provides rich and concise rationale explaining the reasoning behind any identified changes, including specific references, location of documentation, etc
• Keeps abreast of regulatory changes
• Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution
• Provides coder education via the auditing process
• Function in a professional, efficient and positive manner
• Adhere to the American Health Information Management Association(AHIMA)'s code of ethics
• Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
• High complexity of work function and decision making
• Strong organizational, teamwork, and leadership skills

What You Need to Succeed:

• 5+ years of Professional Fee coding and/or auditing
• CPC (required)
• CPMA (preferred)
• Maintain 95% accuracy rate
• Experience with various software including Epic, Cerner, and other prevalent EMRs

What We Offer:

• Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays
• Free CEUs every year
• Stipend provided to assist with education and professional dues (AHIMA/AAPC) If Applicable
• Equipment: monitor, laptop, mouse, headset, and keyboard
• Comprehensive training led by a credentialed professional coding manager
• Exceptional service-style management and mentorship (we're in this together!)

Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role.

To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.
This job is not eligible for employment sponsorship.
Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.To learn more about our commitment, please review our EEO Commitment Statement here . Know Your Rights , explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay.

At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren’t even able to see whether you’ve responded.) Responding is entirely optional and will not affect your application or hiring process in any way.

As set forth in Datavant's Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

Veteran Status

Race, Gender

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection. As a government contractor subject to the Vietnam Era Veterans' Readjustment Assistance Act (VEVRAA), we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categories is as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval, or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval, or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

Datavant recognizes the importance of information security and data privacy, including in its hiring processes and recruitment. Datavant encourages all potential job applicants to take precautions against potential phishing schemes or other scams that improperly purport to be from Datavant or from Datavant representatives.

Datavant is the data collaboration platform trusted for healthcare. With a mission to make the world’s health data secure, accessible, and actionable, Datavant works with payers, providers, life sciences, legal and insurance clients globally to accelerate insights. Datavant enables more than 60 million healthcare records to move between thousands of organizations across the healthcare ecosystem, more than 80,000 hospitals and clinics, 75% of the 100 largest health systems, and 350+ real-world data partners. Datavant has office locations in Boston, New York and San Diego, with international offices in Barcelona and Galway.