Remote Outpatient Coding Quality Auditor

RemoteFetch; Town of Texas (WI); Remote; USD 60,000 - 86,000; Full time

Benefits offered by this job

Health benefits

401(k) match

Paid time off

Job summary

Gainwell Technologies is seeking a Lead Associate, Outpatient Coding Quality Auditor to conduct complex coding quality reviews of medical records and related documentation. You will serve as a subject matter expert in outpatient coding and perform independent audits of coding and clinical staff work products.

You will apply contract-specific methodologies, ensure compliance with regulatory and payer requirements, and document findings and recommendations using our audit systems.

Qualifications

• Active AHIMA or AAPC credential required (CPC, COC, CCS, RHIA, RHIT)
• 3+ years experience in outpatient medical record coding
• Experience auditing outpatient coding and ensuring regulatory compliance

Responsibilities

• Conduct detailed reviews of medical records and claims to validate ICD-10-CM, CPT, HCPCS Level II assignments.
• Apply contract-specific methodologies to identify discrepancies, errors, and reimbursement issues.
• Document audit findings, rationale, and recommendations with audit systems.
• Provide expert guidance on outpatient coding and payment integrity principles.

Skills

AHIMA/AAPC credentials

Outpatient coding experience

Regulatory knowledge

Job description

Gainwell Technologies is seeking a Lead Associate, Outpatient Coding Quality Auditor to conduct complex coding quality reviews of medical records and related documentation. You will serve as a subject matter expert in outpatient coding and perform independent audits of coding and clinical staff work products.

You will apply contract-specific methodologies, ensure compliance with regulatory and payer requirements, and document findings and recommendations using our audit systems.