Perform remote audits of inpatient, ambulatory surgery, observation, and outpatient encounters to ensure accurate ICD-10 and CPT coding for reimbursement and regulatory compliance. Serve as a coding SME, train and advise coding staff, conduct focused audits, report coder accuracy and productivity, collaborate with clinical documentation teams, and ensure adherence to AHIMA ethical coding standards.
This is a remote position.
PLEASE NOTE:
- It is a remote position.
- Schedule: Full-time.
- Shift hours can be flexible and discussed with the manager. The core business hours are 6.00 AM - 6.00 PM
- Must be based in EST or CST hours (cannot recruit from Hawaii, Alaska, or California).
- Assessment will be given to qualified candidates identified by client. Assessment will need to be completed and scored before proceeding with interview
- Must have their own equipment to work from.
- Must have reliable internet and a secure work environment.
- Interviews could be web ex or teams.
- Temp to hire.
- Coversheet is required when submitting candidates
JOB SUMMARY:
Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems.
JOB RESPONSIBILITIES:
KEY RESPONSIBILITY 1:
- Serves as a clinical coding subject matter expert, and utilizes critical thinking analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed.
- Audits ICD-10 diagnostic codes and CPT-4 procedure codes outpatient, ambulatory surgery, and observation visits for the purpose of reimbursement, research and compliance with federal and state regulations.
- Audits complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature ensure accurate APR-DRG/SOI/ROM and POA assignment.
KEY RESPONSIBILITY 2:
- Serves in an advisory and educator role for Coding Specialists. Serves as communicator between Clinical Documentation Specialists and Coding. Researches new surgical procedures and technology. Provides training to new employees
- Reports coding quality accuracy rate for each coder
- Monitors productivity rate for each coder
- Conducts specialized focused audits as needed.
Key Responsibility 3:
- Communicates with various departments within the hospitals regarding coding accuracy. Refers any problems to management timely, providing clear details.
- Assist coding specialists in writing appropriate coding queries, works collaboratively with CDI, understand Potentially Preventable Complications (PPC’s)/Maryland Hospital Acquired Conditions (MHAC’s), Prevention Quality Indicators (PQI’s) and their impact and other indicators as needed.
KEY RESPONSIBILITY 4:
- Complies with AHIMA standards of ethical coding and coding compliance guidelines.
KEY RESPONSIBILITY 5:
- Demonstrates support and compliance with client mission, vision, values statement, goals and objectives and policies. Performs other duties or projects such as coding corrections as assigned by the manager.
Requirements
REQUIRED QUALIFICATIONS:
EDUCATION:
- High School graduate or equivalent. Formal ICD-10-CM, ICD-10-PCS, CPT-4 training.
- Associates or Bachelor’s degree. Education will be considered in lieu of experience.
EXPERIENCE:
- Minimum of two years ICD-10-CM/ICD-10-PCS coding and abstracting experience with at a Level 1 Trauma hospital or 4 years of experience with coding inpatient hospital medical records. 2-3 Years Ambulatory coding experience.
- Must have inpatient auditing experience
CERTIFICATIONS:
One of the following:
- Certified Coding Specialist (CCS)
- Registered Health Information Technician (RHIT)
- Registered Health Information Administrator (RHIA)
- Certified Inpatient Coder (CIC)
Similar Jobs
Cloud • Information Technology • Consulting • Cybersecurity
Audit inpatient, ambulatory surgery, observation and outpatient encounters for accurate ICD-10 and CPT coding, reimbursement, and regulatory compliance. Provide coder education, conduct focused audits, report quality/productivity, collaborate with CDI and clinical staff, and ensure AHIMA ethical coding standards.
Top Skills:
AhimaApr-DrgCdiCpt-4Icd-10-CmIcd-10-PcsMhacPoaPpcPqiRomSoi
Healthtech
Conduct routine and focused coding audits of pediatric outpatient and telehealth records to ensure CMS, Medicaid, and payer compliance. Identify documentation gaps and coding discrepancies, provide audit-defensible recommendations and education to providers and coding staff, perform follow-up validation, produce reports for Compliance Leadership, and serve as subject matter expert on pediatric, Medicaid, telehealth, and behavioral health coding across multiple markets.
Top Skills:
Athena HealthCptDrgE/M CodingEmrHcpcsHedisIcd-10
Healthtech • Professional Services • Pharmaceutical • Telehealth
Perform E/M coding audits, summarize findings, communicate results, and provide follow-up education. Respond to audit requests, tickets, and emails; support physicians and claims resolution specialists; update training materials and SOPs; assist with government audits and contribute to team training and process improvements. Maintain confidentiality and comply with federal/state regulations.
Top Skills:
ExcelOutlookPowerPointSharepointWord
What you need to know about the Austin Tech Scene
Austin has a diverse and thriving tech ecosystem thanks to home-grown companies like Dell and major campuses for IBM, AMD and Apple. The state’s flagship university, the University of Texas at Austin, is known for its engineering school, and the city is known for its annual South by Southwest tech and media conference. Austin’s tech scene spans many verticals, but it’s particularly known for hardware, including semiconductors, as well as AI, biotechnology and cloud computing. And its food and music scene, low taxes and favorable climate has made the city a destination for tech workers from across the country.
Key Facts About Austin Tech
- Number of Tech Workers: 180,500; 13.7% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Dell, IBM, AMD, Apple, Alphabet
- Key Industries: Artificial intelligence, hardware, cloud computing, software, healthtech
- Funding Landscape: $4.5 billion in VC funding in 2024 (Pitchbook)
- Notable Investors: Live Oak Ventures, Austin Ventures, Hinge Capital, Gigafund, KdT Ventures, Next Coast Ventures, Silverton Partners
- Research Centers and Universities: University of Texas, Southwestern University, Texas State University, Center for Complex Quantum Systems, Oden Institute for Computational Engineering and Sciences, Texas Advanced Computing Center
