Remote Medical Auditor – ICD-10 & Compliance

AnewHealth; United States; Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical/dental/vision

401(k)

Paid Time Off

Remote work flexibility

Job summary

AnewHealth, a leading national pharmacy care management firm, seeks a Medical Auditor to work remotely across the United States. You will review patient encounters for completeness and accurate ICD-10 coding, perform chart audits, and help clients stay compliant with HIPAA and coding guidelines.

The ideal candidate has professional medical coding credentials (CCS or CPC) and CDI/HCC experience, with familiarity in Medicare Advantage and managed care systems.

Qualifications

• This role requires professional Medical Coder certification and expertise in ICD-10 coding.
• Experience in Clinical Documentation Improvement (CDI) and HCC is preferred.
• Familiarity with Medicare Advantage and managed care systems is desirable.

Responsibilities

• Perform clinical validation audits and interpret medical documentation for coding accuracy.
• Conduct prospective, retrospective, and RADV audits as requested by clients.
• Integrate coding principles into audit activity and educate clients when needed.
• Prepare detailed audit findings and client reports.
• Monitor and discuss audit results with clients on a monthly basis.
• Provide feedback and process improvement recommendations to Client Service Liaison.

Skills

Medical coding

CDI

HCC

HIPAA

MS Word/Excel

Education

CCS

CPC

RHIT

CRC/CPMA (preferred)

Tools

MS Office

Job description

AnewHealth, a leading national pharmacy care management firm, seeks a Medical Auditor to work remotely across the United States. You will review patient encounters for completeness and accurate ICD-10 coding, perform chart audits, and help clients stay compliant with HIPAA and coding guidelines.

The ideal candidate has professional medical coding credentials (CCS or CPC) and CDI/HCC experience, with familiarity in Medicare Advantage and managed care systems.