Remote Coding Auditor – Healthcare Billing Compliance

Healthcare Fraud Shield; Chesterfield (MO); On-site; USD 55,000 - 85,000; Full time

Benefits offered by this job

Medical insurance

Dental & Vision insurance

401(k) matching

Paid time off

Holidays (7) + floating holidays

Maternity/paternity leave

Disability & Life insurance

FSA

EAP

Job summary

Healthcare Fraud Shield is seeking a Coding Auditor, a professional coder who will review medical records and coding accuracy against billed ICD-10-CM, CPT, HCPCS, and Revenue codes. Under SIU leadership, you will perform routine reviews and document findings to support compliant reimbursement.

The role requires strong attention to detail, knowledge of coding guidelines, and strict adherence to privacy and security standards.

Qualifications

• Knowledge of medical terminology.
• Knowledge of CPT, HCPCS, Revenue Codes, DRG Codes, and ICD-10.
• Knowledge of specialty medical practices.
• Must be detail oriented.
• Ability to communicate effectively both verbally and in writing.
• Strong listening skills.
• Independent.
• Responsible.
• Self-disciplined.
• Ability to meet defined performance and production goals.
• Strong computer skills.
• Access to confidential information requires discretion.

Responsibilities

• Compare the procedures and codes billed on a claim to a medical record.
• Compare information submitted on the claims in order to determine amount and nature of billable services as needed.
• Determines appropriateness of billing and reimbursement as needed.
• Documents findings for each claim line in a spreadsheet as needed.
• Summarize findings in a written report as needed.
• Abstracts CPT, HCPCS, Revenue Codes, DRG codes, and ICD-10 from medical records as needed.
• Responsible for maintaining current knowledge of coding guidelines and relevant federal and/or state regulations as needed.
• Understands and complies with all company Privacy and Security standards.
• Employee may not use or disclose any protected health information, except as otherwise permitted, or required, by law.
• On average, there are a minimum of 5-10 claim line reviews per hour.
• Other duties as needed.

Skills

Medical terminology

Medical coding (CPT/HCPCS/DRG/ICD-10)

Specialty coding knowledge

Detail oriented

Communication skills

Listening skills

Independence

Self-discipline

Performance goals

Computer literacy

Confidentiality

Education

Investigation experience

CPC

CCS

CCA

Job description

Healthcare Fraud Shield is seeking a Coding Auditor, a professional coder who will review medical records and coding accuracy against billed ICD-10-CM, CPT, HCPCS, and Revenue codes. Under SIU leadership, you will perform routine reviews and document findings to support compliant reimbursement.

The role requires strong attention to detail, knowledge of coding guidelines, and strict adherence to privacy and security standards.