Profee Audit Specialist - FT

Datavant; Oregon; Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Medical, Dental, Vision

401k with match

Paid time off

Paid Holidays & Floating Holidays

Free CEUs annually

Education stipend for AHIMA/AAPC

Equipment provided

Job summary

Datavant is seeking a Profee Audit Specialist to perform professional fee coding audits on medical records using ICD-10-CM, CPT, HCPCS and modifiers. This full-time, remote role emphasizes accuracy, regulatory awareness, and clear justification for any coding changes.

You will collaborate with clients and internal teams, educate coders through the audit process, and uphold AHIMA ethics. Remote work offers a flexible schedule and opportunities to advance in healthcare data integrity.

Qualifications

• 5+ years of Professional Fee coding and/or auditing.
• CPC certification is required.
• CPMA certification is preferred.
• Maintain 95% accuracy rate.

Responsibilities

• Performs Professional Fee coding audits of medical records using ICD-10-CM, CPT, HCPCS and modifiers.
• Provides rationale with specific references and locations in documentation.
• Keeps abreast of regulatory changes.
• Organizes and prioritizes multiple cases to sustain workflow.
• Educates coders through the auditing process.
• Acts in a professional, efficient and positive manner.
• Adheres to AHIMA’s code of ethics.
• Demonstrates customer-service focus and professionalism.
• Handles high complexity of work and decision making.
• Exhibits strong organizational, teamwork and leadership skills.

Skills

Professional Fee auditing

Coding audits

Regulatory awareness

Education

CPC

CPMA

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!

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.