Remote ProFee Coding Auditor – Inpatient & Outpatient QA

GeBBS Healthcare Solutions, Inc.; United States; Teletrabalho; USD 31 000 - 44 000; Tempo parcial

Vantagens oferecidas por esta oferta de emprego

Remote work

Resumo da oferta

GeBBS Healthcare Solutions is seeking an experienced Professional Fee (ProFee) Inpatient & Outpatient Coding Auditor to join the team in a remote, part-time capacity. The role focuses on auditing hospital-based professional fee coding, ensuring accuracy, compliance, and education for coding professionals.

You will review ICD-10-CM, CPT, HCPCS, and modifiers, prepare audit reports, and support quality improvement initiatives while meeting productivity targets.

Qualificações

• Minimum 3 years of professional fee coding in hospital-based settings.
• Minimum 2 years in auditing, QA, compliance, or coding education.
• Active CPC/CPMA or AHIMA/AAPC certification required.
• Strong proficiency in ICD-10-CM, CPT, HCPCS Level II, and modifiers.
• Knowledge of payer requirements, reimbursement methods, and guidelines.
• Experience applying Coding Clinic, NCCI, OCE, and payer policies.
• Ability to identify discrepancies and quality improvements.
• Experience providing audit feedback or coaching to staff.
• Proficiency with EHRs, encoders, auditing platforms, and RCM tools.
• Strong analytical, research, documentation, and communication skills.
• Ability to work independently and meet deadlines.

Responsabilidades

• Conduct comprehensive audits of professional fee inpatient/outpatient coding for accuracy and compliance.
• Review records and validate ICD-10-CM, CPT, HCPCS Level II, and modifiers including E/M levels.
• Identify errors, risks, and opportunities for improvement.
• Evaluate modifier usage and code sequencing per guidelines.
• Ensure CMS, ICD guidelines, NCCI/OCE edits, and payer policies compliance.
• Prepare detailed audit reports with findings and recommendations.
• Provide audit feedback, coaching, and coding education.
• Monitor quality trends and root causes; propose corrective actions.
• Collaborate with leadership and operations on QA initiatives.
• Research coding updates and payer guidelines to stay compliant.
• Meet productivity, quality, and turnaround targets.

Conhecimentos

Professional fee coding

Auditing & QA

Regulatory knowledge

Communication skills

Independent work

Formação académica

CPC/CPMA certification (AHIMA/AAPC)

Ferramentas

EHR systems

Encoder software

Auditing platforms

CAC tools

Microsoft Excel

Reporting tools

Epic

Descrição da oferta de emprego

GeBBS Healthcare Solutions is seeking an experienced Professional Fee (ProFee) Inpatient & Outpatient Coding Auditor to join the team in a remote, part-time capacity. The role focuses on auditing hospital-based professional fee coding, ensuring accuracy, compliance, and education for coding professionals.

You will review ICD-10-CM, CPT, HCPCS, and modifiers, prepare audit reports, and support quality improvement initiatives while meeting productivity targets.