Remote Medical Coder & FWA Auditor (Contract)

Randstad NV; United States; Remote; USD 27,000 - 39,000; Full time

Benefits offered by this job

Medical

Prescription

Dental

Vision

AD&D

Life insurance

Short-term disability

401K plan

Job summary

Randstad is seeking a 100% remote Program Integrity Coder - FWA Auditor for a 3-6 month contract. The role entails verifying the accuracy of itemized claim reviews, coding and billing guidance per provider agreements and national audit guidelines.

Requires active CPC/CPC-like certification and 2 years of related experience. Knowledge of ICD-10-CM/PCS, HCPCS/CPT, and DRG systems is essential, with strong analytical and documentation skills.

Qualifications

• 2 years of experience reviewing and auditing medical records.
• Experience in health plan or health insurance environment preferred.
• Ability to abstract information from medical records to ensure coding guidelines are met.

Responsibilities

• Work with SIU Investigators to discuss and determine coding outcomes.
• Analyze patient medical records for FWA investigations.
• Compare claim submissions to determine billable services and amounts.
• Determine appropriateness of billing and reimbursement.
• Document findings in spreadsheets and write reports.
• Abstract CPT, HCPCS, Revenue Codes, DRG codes, and ICD-10 from records.
• Maintain current knowledge of coding guidelines and regulations.

Skills

ICD-10

Medicare Compliance

Certified Professional Coder

Education

Bachelor's degree

Job description

Randstad is seeking a 100% remote Program Integrity Coder - FWA Auditor for a 3-6 month contract. The role entails verifying the accuracy of itemized claim reviews, coding and billing guidance per provider agreements and national audit guidelines.

Requires active CPC/CPC-like certification and 2 years of related experience. Knowledge of ICD-10-CM/PCS, HCPCS/CPT, and DRG systems is essential, with strong analytical and documentation skills.