Remote Quality Validation Auditor - Outpatient Coding

Machinify; United States; A distancia; USD 95.000 - 116.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

PTO

Paid Holidays

Volunteer Days

Health Coverage (Medical/Dental/Vision

401(k) match

Tuition Reimbursement

Remote/Hybrid work options

Life Insurance

Descripción de la vacante

Machinify seeks a Quality Validation Specialist to oversee outpatient coding validation audits. You will ensure accuracy, adherence to official coding guidelines, and compliance with payer policies while supporting continuous improvement in the validation process.

You will partner with leadership to enhance audit quality, provide coaching to auditors, and maintain QA tools and documentation standards in a fast-paced healthcare environment. Remote US options available.

Formación

• Requires Associate/Bachelor in HIM or related field.
• Current AHIMA and/or AAPC certification are required.
• Minimum 5 years outpatient coding or APC validation auditing experience.
• Strong CPT/HCPCS ICD-10-CM knowledge and Medicare OPPS understanding.
• Experience with encoder/auditing tools like Optum, TrueBridge, 3M preferred.

Responsabilidades

• Perform secondary reviews of outpatient coding validation audits for accuracy and compliance.
• Evaluate auditor performance against quality benchmarks and identify trends.
• Provide actionable feedback and coaching to auditors on coding guidelines.
• Develop and maintain QA tools, scorecards, and documentation standards.
• Collaborate with leadership to improve audit methodologies and processes.
• Monitor QA metrics and report findings to leadership.

Conocimientos

Auditing & QA

Coding accuracy

Analytical thinking

Communication skills

Independent work

Educación

Bachelor's or Associate in HIM/Health Admin

AHIMA/AAPC certification

Herramientas

Optum

TrueBridge

3M Auditing tools

Descripción del empleo

Machinify seeks a Quality Validation Specialist to oversee outpatient coding validation audits. You will ensure accuracy, adherence to official coding guidelines, and compliance with payer policies while supporting continuous improvement in the validation process.

You will partner with leadership to enhance audit quality, provide coaching to auditors, and maintain QA tools and documentation standards in a fast-paced healthcare environment. Remote US options available.