Remote Inpatient/Outpatient Coding Auditor

Fidelity Partners; United States; Remote; USD 43,000 - 62,000; Full time

Job summary

Fidelity Partners, a remote inpatient/outpatient coding auditor, seeks qualified professionals to review facility coding for VISN 7 across the United States. The role emphasizes accuracy, documentation sufficiency, DRG use, compliance, and financial impact, with education provided to facilities. Must be a U.S.

citizen with English proficiency and hold an RHIA/RHIT/CCS/CCS-P/CPC or CPC-H credential. Remote work within the U.S.

Qualifications

• Must be a U.S. citizen with English proficiency.
• Active RHIA, RHIT, CCS, CCS-P, CPC, or CPC-H credential.
• At least two years of coding experience in the applicable area.
• At least three years of consultant experience reviewing records in large tertiary-care hospitals and outpatient organizations.
• Three years of education and training experience and ability to present audit findings.
• Proficient with ICD-10-CM/ICD-10-PCS, CPT, HCPCS Level II, DRG, modifiers, bundling, documentation, and compliance.
• Must complete Low Risk NACI background process and VA training.
• Must work securely within the United States with audit accuracy ≥95% and meet reporting/turnaround requirements.

Responsibilities

• Audit inpatient and outpatient facility coding for accuracy and reimbursement impact.
• Evaluate ICD-10-CM/PCS, CPT, HCPCS Level II and DRG assignments.
• Review inpatient hospitalizations and outpatient encounters as assigned.
• Assess diagnoses, procedures, documentation sufficiency, and guidance.
• Identify noncompliant codes, modifiers, or data elements.
• Document findings with supporting authority and financial impact.
• Maintain audit accuracy ≥95% and participate in calibration processes.
• Prepare reports and deliver facility-specific coding education.

Skills

Credential in RHIA/RHIT/CCS/CCS-P/CPC

Coding experience (2+ years)

Consultant experience (3+ years)

Education & training experience (3+ y)

Audit documentation & reporting

Healthcare data accuracy

Education

Coding credential (RHIA/RHIT/CCS/CCS-P/CPC/CPC-H)

Job description

Remote Inpatient/Outpatient Coding Auditor

VISN 7 Health Information Management Services - Remote United States

This Position Is Contingent Upon Contract Award

Work Location

Department of Veterans Affairs

Veterans Health Administration

Veterans Integrated Service Network 7

Health Information Management Services

Remote within the United States

Supporting VISN 7 medical facilities

Fully remote coding and auditing services

Citizenship / Access Requirements: U.S. citizenship and English-language proficiency are required for VA system access. Personnel must satisfy all VA onboarding, identity-verification, training, and access requirements applicable to the position.

Security Requirements: No classified clearance is specified. The position is designated Low Risk and requires a favorable National Agency Check with Inquiries background investigation, annual VA privacy and security training, and all applicable system-access approvals.

Number of FTEs: Not specified. Staffing must be sufficient to meet assigned workload, quality, accuracy, and turnaround requirements.

Type of Employment: Full-Time or Part-Time, based on assigned workload.

Estimated Total Compensation: $38.00 per hour.

Working Hours: No fixed individual shift is specified. Remote schedules are assignment-dependent and must support required turnaround times and coverage aligned with Charleston VA Medical Center business hours.

Work Arrangement: Fully remote within the United States. All work must be physically performed in the United States using approved equipment, software, encoder tools, internet connectivity, reference resources, and a secure workspace.

Period of Performance: January 1, 2027 through December 31, 2031, if all four option periods are exercised.

Summary of Services

The Inpatient/Outpatient Coding Auditor will independently review inpatient and outpatient facility coding for VISN 7. The auditor will assess code accuracy, documentation sufficiency, DRG and modifier use, compliance, and financial impact; report findings; recommend improvements; and provide facility-specific education.

Mandatory Qualifications

Must be a U.S. citizen and be able to read, write, speak, and understand English.

Must satisfy the coder education and credential requirements, including an active RHIA, RHIT, CCS, CCS-P, CPC, or CPC-H credential.

Must have at least two years of coding experience in the applicable coding area.

Must have at least three years of consultant experience reviewing records in large tertiary-care hospitals and outpatient organizations with primary care and subspecialty services.

Must have at least three years of education and training experience and be able to present audit findings and facility-specific coding education.

Must be proficient with applicable ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, DRG, modifier, bundling, reimbursement, documentation, and compliance requirements.

Must successfully complete the Low Risk NACI background process and all required VA privacy, information-security, and mandatory training.

Must be able to work securely within the United States, maintain audit accuracy of at least 95 percent, and meet all reporting and turnaround requirements.

Duties and Responsibilities

Independently audit inpatient and outpatient facility coding for accuracy, documentation support, compliance, and reimbursement impact.

Evaluate ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, evaluation and management, modifier, bundling, present-on-admission, procedure, and DRG assignments.

Review inpatient hospitalizations and outpatient clinic, urgent-care, radiology, laboratory, ancillary, observation, and ambulatory surgical encounters as assigned.

Assess principal and secondary diagnoses, procedure coding, documentation sufficiency, billability, and applicable inpatient and outpatient coding guidance.

Identify incorrect, missing, duplicate, unbundled, unsupported, upcoded, downcoded, or otherwise noncompliant codes, modifiers, and data elements.

Review relevant documentation in the electronic health record and approved audit tools using established sampling requirements.

Document each finding with clear supporting authority, financial impact, risk, and recommended corrective action.

Maintain audit accuracy of at least 95 percent and participate in calibration processes that support inter-reviewer consistency.

Contribute to audit work plans, collection tools, facility reports, consolidated reports, and required progress updates.

Review preliminary findings with HIMS leadership, the COR, management, and designated facility personnel.

Prepare or support final reports addressing accuracy, documentation issues, financial impact, process improvement, and educational needs.

Develop and deliver facility-specific coding education, support exit conferences, and explain findings using authoritative guidance.

Protect VA information and meet all audit schedules, reporting deadlines, training requirements, credential requirements, and access requirements.

About Us

Fidelity Partners is an Inc. 5000 USA company that provides medical, technical, logistical, and administrative services to the federal government and commercial clients across the country. Fidelity offers competitive salaries and benefits packages.

Fidelity Partners provides equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, or any other status protected in accordance with applicable federal, state, and local laws (EOE).