Remote CA Medical Coding Auditor – Risk-Based Audits

DaMar Staffing; United States; On-site; USD 55,000 - 96,000; Part time

Job summary

DaMar Staffing is seeking a part-time California Licensed Medical Coding Auditor to conduct risk-based audits on professional coding and billing workflows, validating code assignments and compliance remotely.

The role involves validating code assignments, documentation, medical necessity, and modifier usage through prospective and retrospective audits, while communicating findings to physicians and APCs and managing multiple audits with tight deadlines.

Qualifications

• 5+ years of professional coding, billing, or healthcare audit experience, including risk-based auditing.
• Advanced knowledge of CPT, HCPCS, ICD-10-CM, modifiers, and current E/M guidelines.
• Experience with Medicare, Medi-Cal, and commercial payer policies, including CMS manuals and NCDs/LCDs.
• Proficiency in Epic charge review and coding documentation.
• Ability to analyze audit results and develop defensible audit samples.

Responsibilities

• Validate code assignment, documentation, medical necessity, and modifier usage through prospective and retrospective audits.
• Analyze error trends and financial impacts while developing appropriate audit samples and maintaining consistent documentation.
• Communicate findings and recommend improvements to physicians and APCs, managing multiple concurrent audits and reporting deadlines.

Skills

Healthcare auditing

CPT/HCPCS

ICD-10-CM

E/M guidelines

Medicare/ Medi-Cal

Risk-based auditing

Epic

Tools

Epic

Job description

DaMar Staffing is seeking a part-time California Licensed Medical Coding Auditor to conduct risk-based audits on professional coding and billing workflows, validating code assignments and compliance remotely.

The role involves validating code assignments, documentation, medical necessity, and modifier usage through prospective and retrospective audits, while communicating findings to physicians and APCs and managing multiple audits with tight deadlines.