Remote Professional Fee Coding Auditor — Healthcare Audit Expert

AAPC; United States; Remote; USD 47,000 - 58,000; Full time

Job summary

Fidelity Partners is hiring a Remote Professional Fee Coding Auditor to independently review inpatient and outpatient professional-fee coding for VISN 7. The role emphasizes documentation sufficiency, coding accuracy, and compliance with reimbursement impact, delivering facility-specific education and recommendations.

The position requires U.S. citizenship, active AHIMA or AAPC credentials, and 2+ years of coding experience plus 3+ years in audit/consulting within large hospitals and ambulatory

Qualifications

• Must be a U.S. citizen and able to read, write, speak, and understand English.
• Active AHIMA or AAPC credential (RHIA, RHIT, CCS, CCS-P, CPC, or CPC-H).
• At least two years of coding experience in the applicable coding area.
• At least three years of consultant experience reviewing records in large tertiary-care hospitals and outpatient organizations.
• At least three years of education and training experience and ability to present audit findings and facility-specific coding education.
• Proficient with ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, DRG, modifier, bundling, reimbursement, documentation, and compliance requirements.
• Must successfully complete the Low Risk NACI background process and VA privacy, information-security, and mandatory training.
• Must be able to work securely within the United States, maintain audit accuracy of at least 95 percent, and meet all reporting and turnaround requirements.

Responsibilities

• Independently audit inpatient and outpatient professional-fee coding for accuracy, documentation support, compliance, and reimbursement impact.
• Evaluate ICD-10-CM, CPT, HCPCS Level II, evaluation and management, modifier, professional-component, and bundling assignments.
• Verify provider information, scope of practice, billability, and documentation support for reported professional services.
• Identify incorrect, missing, unbundled, upcoded, downcoded, unsupported, or otherwise noncompliant codes and modifiers.
• Review relevant diagnoses and procedures in the electronic health record and approved audit tools using established sampling requirements.
• Document each finding with clear supporting authority, financial impact, risk, and recommended corrective action.
• Maintain audit accuracy of at least 95 percent and participate in calibration processes that support inter-reviewer consistency.
• Contribute to audit work plans, collection tools, facility reports, consolidated reports, and required progress updates.
• Review preliminary findings with HIMS leadership, the COR, management, and designated facility personnel.
• Prepare or support final reports addressing accuracy, documentation issues, financial impact, process improvement, and educational needs.
• Develop and deliver facility-specific coding education and support exit conferences when assigned.
• Protect VA information and follow all privacy, information-security, encryption, and remote-work requirements.
• Meet all assigned audit schedules, reporting deadlines, training requirements, credential requirements, and access requirements.

Job description

Fidelity Partners is hiring a Remote Professional Fee Coding Auditor to independently review inpatient and outpatient professional-fee coding for VISN 7. The role emphasizes documentation sufficiency, coding accuracy, and compliance with reimbursement impact, delivering facility-specific education and recommendations.

The position requires U.S. citizenship, active AHIMA or AAPC credentials, and 2+ years of coding experience plus 3+ years in audit/consulting within large hospitals and ambulatory