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Quality Auditor- Remote
About the position The Quality Auditor – Multispecialty Medical Coding is responsible for ensuring the accuracy, integrity, and compliance of medical coding across multiple specialties. This role performs comprehensive audits of inpatient, outpatient, and professional fee coding to verify alignment with official coding guidelines, payer requirements, and regulatory standards. The auditor provides actionable feedback and education to coding teams to improve quality, compliance, and reimbursement accuracy. Responsibilities • Conduct routine and focused coding audits across multiple medical specialties (e.g., cardiology, orthopedics, general surgery, gastroenterology, radiology, internal medicine, etc.). • Review CPT®, ICD-10-CM, and HCPCS Level II coding for accuracy, completeness, and compliance with CMS, OIG, and payer-specific rules. • Evaluate medical record documentation to ensure accurate code assignment and adherence to medical necessity and coding guidelines. • Identify trends, patterns, and recurring coding errors; collaborate with coders and leadership to implement corrective actions. • Prepare detailed audit reports summarizing findings, accuracy rates, and recommendations for improvement. • Provide one-on-one or group coder education and feedback based on audit outcomes. • Assist in the development and maintenance of internal audit tools, policies, and training materials. • Stay current on coding updates, compliance regulations, and industry best practices. • Participate in internal compliance reviews and support external audits as needed. • Contribute to process improvement initiatives that enhance coding quality and operational efficiency. Requirements • Minimum 5 years of experience in professional or facility coding across multiple specialties. • Minimum 2 years of experience in coding auditing or quality review preferred. • Strong understanding of CPT®, ICD-10-CM, and HCPCS Level II coding systems and payer guidelines. • Experience with EHRs and coding/audit software tools (e.g., 3M, Epic, Optum, or similar). • Exceptional attention to detail and analytical problem-solving ability. • Strong knowledge of compliance standards (e.g., CMS, OIG, HIPAA). • Excellent written and verbal communication skills, with the ability to convey complex coding concepts clearly. • Ability to work independently while managing multiple priorities and deadlines. • Commitment to maintaining confidentiality and ethical auditing practices. • Associate’s or Bachelor’s degree in Health Information Management, Health Administration, or a related field (preferred). • Active coding certification required: CPC, COC, or CCS (AAPC or AHIMA). Nice-to-haves • CPMA (Certified Professional Medical Auditor) or equivalent auditing credential strongly preferred. • Additional specialty credentials (e.g., CIRCC, CDEO, or CCS-P) are advantageous. Benefits • This position is eligible for full health insurance including medical/dental/vision, PTO, and a 401k match! Apply tot his job
