Senior Remote Claim Audit & Coding Specialist

CorroHealth Inc; California (MO); Hybrid; USD 90,000 - 130,000; Full time

Job summary

CorroHealth Inc. is seeking a highly experienced HIM auditor to assist the Director of HIM/Audit Services from a remote USA location.

The role focuses on reviewing and recommending coding and billing changes for outpatient and Profee claims, using our PARA Data Editor to develop standardized reports and respond to client questions in clear English. You must have 5+ years of OP facility coding experience (ER, SDS, OBS, E/M), AHIMA/AAPC certification, and strong knowledge of CMS guidelines.

Qualifications

• 5+ years of current directly related experience in OP facility coding (ER, SDS, OBS, E/M facility).
• Certification: CCS/COC/CPC (AHIMA or AAPC) required; CPC-A not accepted.
• Strong knowledge of CMS guidelines, ICD-10-CM, CPT/HCPCS, MUE and CCI edits.
• Proficient in Excel, PowerPoint, Word; excellent written and verbal communication.

Responsibilities

• Audit all aspects of claims, including omitted or incorrect charges.
• Become proficient in PARA Data Editor and select/review claims for review.
• Review OPPS/CAH charges and apply guidelines; ensure coding accuracy.
• Prepare written QA entries and assist in client web presentations.

Skills

Outpatient coding

Revenue cycle

CPT/HCPCS

ICD-10 CM

Excel

Client communication

Data analysis

Education

AHIMA/AAPC certification (CCS/COC/CPC)

Tools

PARA Data Editor

Microsoft Office

Job description

CorroHealth Inc. is seeking a highly experienced HIM auditor to assist the Director of HIM/Audit Services from a remote USA location.

The role focuses on reviewing and recommending coding and billing changes for outpatient and Profee claims, using our PARA Data Editor to develop standardized reports and respond to client questions in clear English. You must have 5+ years of OP facility coding experience (ER, SDS, OBS, E/M), AHIMA/AAPC certification, and strong knowledge of CMS guidelines.