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.
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 escalate significant issues to the 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.