Remote Medical Auditor: ICD-10 & Compliance

ExactCare Pharmacy; New Jersey; Hybrid; USD 80,000 - 110,000; Full time

Benefits offered by this job

Medical/dental/vision, flexible spend

Company-paid life insurance and short‑

401(k)

Paid Time Off and paid holidays

Job summary

AnewHealth, one of the nation’s leading pharmacy care management companies, is seeking a remote Medical Auditor to review patient encounters for completeness and ICD-10 coding accuracy, ensuring compliance with coding guidelines and third-party policies.

This full-time role involves audits, client reporting, and ongoing professional development to stay current with HIPAA regulations and coding standards.

Qualifications

• Certification in medical coding (CCS or CPC) required.
• Experience with ICD-10-CM coding and documentation.
• Knowledge of HIPAA and healthcare compliance guidelines.

Responsibilities

• Perform clinical validation audits and interpretation of medical documentation to ensure capture of patient conditions in compliance with coding guideline.
• Performs reviews for prospective audits, retrospective audits, and RADV audits when requested by client.
• Integrates coding principles in performance of medical audit activity and educates as needed on those principles.
• Compiles detailed findings and prepares client reports after completing medical record audits.

Skills

Medical coding

HIPAA compliance

Education

CCS (AHIMA)

CPC

RHIT

CRC

CPMA

Tools

MS Word

Excel

PowerPoint

Job description

AnewHealth, one of the nation’s leading pharmacy care management companies, is seeking a remote Medical Auditor to review patient encounters for completeness and ICD-10 coding accuracy, ensuring compliance with coding guidelines and third-party policies.

This full-time role involves audits, client reporting, and ongoing professional development to stay current with HIPAA regulations and coding standards.