Remote Outpatient Coding Compliance Specialist

DaMar Staffing; Montgomery (AL); Remote; USD 73,000 - 130,000; Full time

Benefits offered by this job

Benefits package

Incentive programs

Stock purchase plan

401k contribution

Job summary

Optum is seeking an Outpatient Coding Compliance Auditor to perform audits of outpatient facility coding, ensuring ICD-10-CM, CPT, modifiers and E/M level accuracy in line with guidelines. The role entails QA oversight, trend analysis, and presenting findings to stakeholders.

Remote work is available across the U.S., supporting the Compliance Program and client expectations. Qualifications include CPC/CCS/COC and 5+ years in outpatient facility coding, with experience in NCCI/OCE edits and E/M

Qualifications

• 5+ years of Outpatient Facility coding experience including NCCI/OCE edits, ICD-10-CM and CPT coding
• Knowledge of ACEP Facility or similar Facility E/M guidelines for outpatient coding
• Experience performing audits and identifying trends and root causes

Responsibilities

• Perform coding compliance and quality audits in support of the Compliance Program
• Independently analyze clinical documentation from medical records
• Validate coding accuracy for outpatient facility services, including E/M
• Identify audit findings, calculate error rates, and perform root cause analysis
• Document audit findings and tailor results to the audience
• Prepare audit analyses and reports highlighting risk and corrective actions
• Audit vendor coders and offshore staff as needed
• Stay updated on coding, billing and regulatory guidelines

Skills

Auditing experience

Outpatient coding

Coding compliance

Communication skills

Education

CPC/CCS/COC certification

RHIA/RHIT/CPMA a plus

Tools

Microsoft Excel

Microsoft Teams

Microsoft PowerPoint

Microsoft Outlook

Job description

Optum is seeking an Outpatient Coding Compliance Auditor to perform audits of outpatient facility coding, ensuring ICD-10-CM, CPT, modifiers and E/M level accuracy in line with guidelines. The role entails QA oversight, trend analysis, and presenting findings to stakeholders.

Remote work is available across the U.S., supporting the Compliance Program and client expectations. Qualifications include CPC/CCS/COC and 5+ years in outpatient facility coding, with experience in NCCI/OCE edits and E/M