Remote Medical Coding Compliance Auditor

RiseMe; Pawleys Island (SC); On-site; USD 70,000 - 110,000; Full time

Benefits offered by this job

Remote work

Job summary

RiseMe is seeking a senior compliance auditor to perform CMS, CPT, ICD-10 audits across state and federal guidelines. You’ll prepare concise recommendation worksheets, executive summaries, and present findings during summation calls.

The ideal candidate has a high school diploma with AAPC credential (CPC preferred), 5+ years in multispecialty review, ICD-10-CM training, and proficiency with EHRs and research, with capability to work remotely.

Qualifications

• Must have a high school diploma and at least one AAPC credential; CPC preferred.
• Minimum 5 years review experience in a multispecialty clinic/facility.
• ICD-10-CM training and ability to research coding questions using internal resources.
• Proficient with Electronic Health Record systems and related coding tools.

Responsibilities

• Prepares for Review and plans audit activities.
• Reviews E/M codes based on CMS guidelines (95/97 or 2021).
• Reviews records to ensure correct ICD-10-CM coding and sequencing.
• Reviews CPT reporting per CPT conventions.
• Documents findings with recommendations and educational feedback.
• Researches state/federal and payor guidelines to support recommendations.
• Generates preliminary/final reports and client rebuttals as needed.
• Conducts Summation Conferences with clients and staff.

Skills

AAPC CPC

5+ years review

ICD-10-CM training

EHR proficiency

Remote work

Analytical thinking

Education

High School diploma

AAPC credential

Tools

EHR systems

Coding encoders

Job description

RiseMe is seeking a senior compliance auditor to perform CMS, CPT, ICD-10 audits across state and federal guidelines. You’ll prepare concise recommendation worksheets, executive summaries, and present findings during summation calls.

The ideal candidate has a high school diploma with AAPC credential (CPC preferred), 5+ years in multispecialty review, ICD-10-CM training, and proficiency with EHRs and research, with capability to work remotely.