Profee ED Auditor/QA Specialist

Gebbs Healthcare Solutions Inc; United States; Remote; USD 85,000 - 115,000; Full time

Job summary

GeBBS Healthcare Solutions is seeking a Remote ProFee Emergency Department Coding Auditor / QA Specialist to join our team. The role focuses on auditing professional ED coding, E/M leveling, and ensuring documentation accuracy and regulatory compliance.

The ideal candidate has at least 3 years of ProFee ED auditing experience, CPC/CEMC or equivalent certification, and strong ability to provide actionable feedback to improve coding quality."

Qualifications

• Minimum 3 years of professional coding auditing experience, specifically involving ProFee Emergency Department services.
• Experience with ED E/M leveling and procedure coding.
• Knowledge of ICD-10-CM, CPT, HCPCS and payer guidelines.
• Strong documentation and communication skills.

Responsibilities

• Perform detailed audits of Professional Fee Emergency Department encounters, ensuring accurate E/M leveling, procedure coding, and appropriate code assignment.
• Conduct onboarding coding reviews and quality assessments to support client-specific requirements and standards.
• Review medical documentation for compliance with ICD-10-CM, CPT, HCPCS, and applicable payer guidelines.
• Identify coding discrepancies, documentation deficiencies, missed charges, and opportunities for improved accuracy and compliance.
• Apply current and historical E/M documentation guidelines, including 1995, 1997, and updated 2021 and subsequent guidelines, as applicable to the services being audited.
• Prepare accurate audit reports, summarize findings, and provide recommendations for corrective action.
• Collaborate with coding teams, leadership, and clients to communicate audit findings and support quality improvement initiatives.
• Assist with coder and provider education, including clarification of coding guidelines, documentation requirements and audit findings.
• Maintain established quality and productivity standards while meeting client deadlines.
• Stay current with regulatory updates, coding changes and Medicare, Medicaid and commercial payer requirements.

Skills

ProFee ED auditing

ED E/M leveling

ICD-10-CM

CPT/HCPCS

Regulatory compliance

Auditing feedback

Excel

Word

Education

CEMC/CPC certification

CPMA certification

AHIMA credentials (CCS-P, RHIA, RHIT)

Tools

Excel

Word

Job description

Remote (United States) | Full-Time | Monday–Friday | Flexible Schedule

Position Overview

GeBBS Healthcare Solutions is seeking an experienced Professional Fee (ProFee) Emergency Department Coding Auditor / QA Specialist to join our remote team.

This position is responsible for conducting comprehensive audits of professional Emergency Department coding, with a strong emphasis on ED Evaluation & Management (E/M) leveling, procedure coding, documentation accuracy, and regulatory compliance.

The ideal candidate will have a proven background in ProFee ED auditing, exceptional attention to detail, and the ability to identify coding discrepancies, provide actionable feedback, and support ongoing quality improvement initiatives.

Key Responsibilities

• Perform detailed audits of Professional Fee Emergency Department encounters, ensuring accurate E/M leveling, procedure coding, and appropriate code assignment.
• Conduct onboarding coding reviews and quality assessments to support client-specific requirements and standards.
• Review medical documentation for compliance with ICD-10-CM, CPT, HCPCS, and applicable payer guidelines.
• Identify coding discrepancies, documentation deficiencies, missed charges, and opportunities for improved accuracy and compliance.
• Apply current and historical E/M documentation guidelines, including 1995, 1997, and updated 2021 and subsequent guidelines, as applicable to the services being audited.
• Prepare accurate audit reports, summarize findings, and provide recommendations for corrective action.
• Collaborate with coding teams, leadership, and clients to communicate audit findings and support quality improvement initiatives.
• Assist with coder and provider education, including clarification of coding guidelines, documentation requirements and audit findings.
• Maintain established quality and productivity standards while meeting client deadlines.
• Stay current with regulatory updates, coding changes and Medicare, Medicaid and commercial payer requirements.

Required Qualifications

• Minimum of 3 years of professional coding auditing experience, specifically involving ProFee Emergency Department services.
• Active CEMC and/or CPC certification required.
• Demonstrated expertise in Professional Fee ED E/M leveling and procedure coding — both are required.
• Strong understanding of Emergency Department documentation, medical necessity, modifier usage, and appropriate code assignment.
• Comprehensive knowledge of ICD-10-CM, CPT, HCPCS, and applicable coding and billing regulations.
• Knowledge of E/M documentation guidelines and current coding requirements.
• Experience conducting detailed coding audits, identifying discrepancies and providing constructive feedback.
• Ability to independently complete manual or technology-assisted coding audits.
• Excellent analytical, organizational, written and verbal communication skills.
• Proficiency with Microsoft Office applications, including Excel and Word.
• Ability to manage multiple priorities, maintain accuracy, and consistently meet productivity expectations.
• Must reside in the United States and be available to work Monday through Friday.

Preferred Qualifications

• CPMA certification.
• Additional AHIMA credentials such as CCS-P, RHIA or RHIT.
• Experience with Revenue Integrity and Charge Capture.
• Experience providing coder or physician education and communicating audit findings to stakeholders.
• Familiarity with client-specific onboarding reviews, quality assurance processes, and performance reporting.

Schedule & Performance Expectations

• Employment Type: Full-Time, 40 hours per week.
• Work Location: 100% Remote (United States).
• Schedule: Monday through Friday, 8 hours per day.
• Flexible Working Hours: Following completion of client onboarding, employees may work their daily 8-hour schedule between 5:00 AM and 9:00 PM , based on applicable scheduling requirements. A consistent daily start time is not required.
• Productivity Requirement: Minimum 10 encounters per hour (EPH).

Why Join GeBBS?

At GeBBS Healthcare Solutions, you’ll have the opportunity to apply your specialized auditing expertise while contributing to coding accuracy, compliance, and continuous quality improvement. We offer a collaborative remote environment where your knowledge and attention to detail make a meaningful difference.