New Mexico Licensed Pro Fee Auditor

Job Summary

To support a growing healthcare team, the full-time Remote Pro Fee Auditor/Educator will manage coding compliance, conduct audits, and develop educational programs while working remotely.

Key responsibilities

• Implement and ensure compliance with coding policies and external regulations while conducting audits and reviews
• Research coding and billing compliance issues, recommending corrective action plans and providing compliance education
• Coordinate and track appealed claims, ensuring accurate payment and communication with payers

Required qualifications

• High school diploma/GED and at least one relevant certification (RHIT, RHIA, CPC, CCS) with a minimum of three years of coding/auditing experience
• Proficient knowledge of Medicare, Medicaid, and third-party payer regulations
• Strong understanding of medical terminology, ICD-9, CPT-4, and HCPCS coding systems
• Excellent organizational skills with the ability to prioritize multiple tasks effectively
• Strong written and verbal communication skills to convey complex regulatory information clearly