Outpatient Coding Compliance Auditor

Job Summary

Working remotely from anywhere in the U.S., the full-time Outpatient Coding Compliance Auditor will perform audits of outpatient facility coding to ensure compliance with ICD-10-CM diagnoses, CPT/HCPCS codes, and billing standards while effectively communicating findings to stakeholders.

Key responsibilities:

• Perform coding compliance and quality audits in support of the Compliance Program and client expectations
• Independently analyze clinical documentation from medical records and validate coding accuracy for outpatient facilities
• Identify audit findings and calculate billing error rates, providing follow-up validation for corrective action plans

Required qualifications:

• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Outpatient Coder (COC)
• 5+ years of Outpatient Facility coding experience, including knowledge of NCCI/OCE billing edits
• 5+ years of Outpatient Facility audit experience, including familiarity with Medicare regulations and OPPS
• Proficiency in ICD-10-CM and CPT coding guidelines
• Experience with ACEP Facility or similar Facility E/M matrix guidelines for outpatient coding