Remote Facility Coding Auditor & Claim Optimization

International Association of Insurance Professionals (IAIP); Northern (KY); Hybrid; USD 85,000 - 110,000; Full time

Benefits offered by this job

Medical, Dental, Vision coverage and更多

401K with company match

Certification and Tuition Reimbursed

Job summary

International Association of Insurance Professionals (IAIP) seeks a remote HIM coding auditor to conduct comprehensive claim audits for hospital outpatient and ProFee claims, evaluating coding accuracy and billing compliance using proprietary software. You will identify revenue cycle improvements and support clients in optimizing claim quality and reimbursement outcomes.

The role requires AHIMA or AAPC CPC certification and at least 5 years of hospital outpatient facility coding audit

Qualifications

• Minimum 5 years of hospital outpatient facility coding audit experience.
• Advanced knowledge of ED, SDS, OBS, I&I, E/M, and ancillary outpatient services.
• Experience presenting findings to healthcare clients and leadership.
• Strong understanding of revenue cycle processes, billing principles, and coding compliance.

Responsibilities

• Perform detailed audits of hospital outpatient and ProFee claims to identify coding, billing, charging, and revenue cycle improvement opportunities.
• Review and recommend coding, charge capture, revenue integrity, and claim optimization strategies.
• Utilize proprietary software to analyze audit findings and develop standardized client reports.
• Present audit results and recommendations to clients in a clear, professional manner.
• Respond to coding and compliance-related inquiries with concise written and verbal communication.
• Collaborate with revenue cycle consultants, coding professionals, and client stakeholders to support project goals.
• Develop educational materials, FAQs, and client-facing guidance on coding and billing best practices.
• Assist with special projects and other duties as assigned.

Skills

Communication skills

Attention to detail

Presentation of findings

Written communication

Education

AHIMA or AAPC CPC certification

Job description

International Association of Insurance Professionals (IAIP) seeks a remote HIM coding auditor to conduct comprehensive claim audits for hospital outpatient and ProFee claims, evaluating coding accuracy and billing compliance using proprietary software. You will identify revenue cycle improvements and support clients in optimizing claim quality and reimbursement outcomes.

The role requires AHIMA or AAPC CPC certification and at least 5 years of hospital outpatient facility coding audit