Revenue Cycle Managed Services Coding Auditor

Jobgether SRL; United States; Teletrabalho; USD 70 000 - 110 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Remote work

Flexible scheduling

Professional development

Collaborative environment

Resumo da oferta

Jobgether SRL is seeking a Revenue Cycle Managed Services Coding Auditor in the United States. The role focuses on audits, documentation review, and improving coding accuracy across specialties to optimize reimbursement and compliance.

You will mentor coding staff, develop training materials, and collaborate with clients and revenue cycle teams to strengthen performance and reduce denials.

Qualificações

• Three to five years of medical coding auditing experience.
• Strong working knowledge of CPT, ICD-10-CM, HCPCS, payer-specific coding guidelines.
• Ability to interpret clinical documentation and assess impact on reimbursement.
• Experience conducting coding audits and performing root cause analysis.
• Excellent written and verbal communication, able to provide actionable feedback.
• Experience coaching and mentoring coding staff and delivering training.

Responsabilidades

• Conduct routine, focused, and validation audits of professional medical coding.
• Ensure coding practices align with regulatory requirements.
• Investigate coding errors and track quality metrics and trends.
• Provide audit feedback and develop training based on gaps.
• Create educational resources and onboarding materials for coding staff.
• Support client meetings and communicate documentation, coding, and compliance recommendations.
• Assist in policy development and continuous improvement initiatives.
• Provide production coding support during high-volume periods.
• Collaborate with revenue cycle teams to reduce denials.

Conhecimentos

Auditing

Communication skills

Mentorship

Analytical skills

Client-facing

Training

Denials management

Formação académica

CPC certification

CPMA certification

CCS-P certification

Medical coding certification

Ferramentas

Epic EMR

Physician coding workflows

Descrição da oferta de emprego

Our partner is looking for a Revenue Cycle Managed Services Coding Auditor based in the United States. The Revenue Cycle Managed Services Coding Auditor plays a key role in ensuring accurate, compliant, and high-quality medical coding across multiple professional healthcare specialties. This position focuses on conducting coding audits, evaluating medical documentation, and identifying opportunities to improve coding accuracy, reimbursement outcomes, and regulatory compliance. You will analyze audit findings, investigate recurring coding issues, and provide actionable feedback and education to support continuous improvement. Working closely with coding professionals, healthcare clients, and revenue cycle teams, you will help strengthen operational performance and reduce coding-related denials. The role combines technical coding expertise, analytical problem-solving, and client-facing collaboration in a quality-driven healthcare consulting environment. This remote opportunity is ideal for an experienced coding professional who enjoys mentoring others, resolving complex coding challenges, and contributing to better financial and operational outcomes for healthcare organizations.

Accountabilities

• Coding Audits and Quality Assurance: Conduct routine, focused, and validation audits of professional medical coding across multiple specialties to assess coding accuracy, documentation support, compliance, and reimbursement impact.
• Compliance and Regulatory Standards: Ensure coding practices align with ICD-10-CM, CPT, HCPCS, payer-specific guidelines, and applicable regulatory requirements.
• Root Cause Analysis and Reporting: Investigate coding errors and recurring discrepancies, track audit results and quality metrics, identify performance trends, and elevate significant issues to appropriate leadership.
• Coder Education and Development: Provide actionable audit feedback, mentor coding staff, and develop and deliver individual or group training sessions based on identified knowledge gaps and quality trends.
• Training Materials and Onboarding: Create educational resources, reference guides, and coding documentation while supporting the onboarding, training, and ongoing professional development of coding team members.
• Client Support and Coding Expertise: Serve as a coding subject matter expert for assigned clients, participate in client meetings, research complex coding scenarios, and communicate recommendations on documentation, coding, and compliance.
• Policy Development: Support leadership in developing, reviewing, and implementing coding policies, procedures, and best practices.
• Production Coding Support: Assist with coding production during periods of high volume, staffing shortages, or other operational needs while maintaining established productivity and accuracy standards.
• Denial Management and Revenue Cycle Optimization: Review coding-related denials, identify opportunities for appeals or corrections, and collaborate with coding, revenue cycle, and operations teams to reduce recurring denial patterns.
• Payer Audits and Documentation Reviews: Support payer audit responses, review supporting medical documentation, and recommend corrective actions to strengthen compliance and reimbursement outcomes.
• Continuous Improvement: Monitor coding regulations, industry developments, and payer policy changes; participate in internal and external audits; and recommend process improvements that enhance quality, efficiency, and compliance.
• Special Projects and Collaboration: Contribute to client initiatives, operational projects, and other assignments while managing multiple priorities independently and effectively.

Requirements

• Professional Experience: Three to five years of medical coding auditing experience, with demonstrated expertise in evaluating coding accuracy, reviewing documentation, and delivering constructive audit feedback.
• Medical Coding Knowledge: Strong working knowledge of CPT, ICD-10-CM, HCPCS, payer-specific coding guidelines, and applicable compliance requirements.
• Documentation Review: Proven ability to interpret clinical documentation, apply appropriate coding principles, identify discrepancies, and assess the potential impact on reimbursement.
• Audit and Analytical Skills: Experience conducting coding audits, performing root cause analysis, interpreting quality metrics, and identifying opportunities for process improvement.
• Communication Skills: Excellent written and verbal communication skills, including the ability to explain complex coding issues clearly and provide actionable feedback to coding professionals, clients, and internal stakeholders.
• Education and Mentorship: Ability to coach and mentor coding staff, develop educational materials, deliver training, and support ongoing performance improvement.
• Organizational Skills: Strong analytical, organizational, and problem-solving abilities, with the capacity to work independently, prioritize competing demands, and meet quality and productivity expectations.
• Preferred Specialty Experience: Experience auditing surgical specialties such as obstetrics and gynecology (OB/GYN), orthopedics, and urology. Evaluation and management (E/M) auditing experience is also advantageous.
• Preferred Certifications: Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Coding Specialist–Physician-based (CCS-P), or an equivalent medical coding certification.
• Preferred Technical Experience: Familiarity with Epic electronic medical records (EMR) systems and professional or physician-fee coding workflows.
• Client-Facing Experience: Previous experience working directly with healthcare clients and communicating coding recommendations or compliance findings.
• Revenue Cycle Knowledge: Understanding of denial management, claims appeals, reimbursement processes, and strategies for reducing coding-related denials.
• Training Experience: Experience developing coding education programs, training resources, and structured feedback processes.
• Work Arrangement: Ability to work remotely within the United States and maintain a flexible schedule aligned with client and project requirements.

Benefits

• Remote Work: Remote-friendly position offering the flexibility to work from home.
• Flexible Scheduling: Scheduling flexibility based on project requirements and operational needs.
• Compensation: Hourly, non-exempt position. Compensation details are determined based on relevant skills, experience, training, certifications, and organizational requirements. A specific hourly pay range was not provided in the original posting.
• Potential Performance Bonus: Annual performance bonuses may be available for eligible salaried positions; eligibility for this hourly role is not specified.
• Additional Benefits and Perks: Other benefits and perks may be available depending on the position and employment terms; specific healthcare, retirement, and paid leave details were not provided.
• Professional Development: Opportunities to expand coding expertise, participate in training initiatives, and contribute to continuous quality improvement.
• Collaborative Environment: Work alongside experienced coding professionals, healthcare consultants, and revenue cycle specialists.
• Meaningful Healthcare Impact: Help healthcare organizations improve coding quality, strengthen compliance, reduce denials, and support more effective financial and operational performance.
• Inclusive Culture: Join a professional environment that emphasizes collaboration, integrity, autonomy, diverse perspectives, and employee development.

We appreciate your interest and wish you the best!