Medical Auditor Remote Focused on Outpatient Coding and QA
Overview
Remote Medical Auditor with a track record in outpatient professional fee coding and audit program oversight. You’ll review and certify coding accuracy for an academic medical center project and help train AI systems by providing high-quality, real-world input. Prior experience in an academic medical center environment is highly valued, along with strong written feedback skills and attention to detail. Expect to handle around 10 reviews daily and contribute to QA activities as needed. Outpatient professional fee coding, E/M leveling, modifier -25, time vs. MDM, and NCCI bundling are core domains you’ll apply every day.
What You'll Do8
- 1Audit outpatient professional fee coding for accuracy and regulatory compliance.
- 2evaluate peers' coding work to spot errors, gaps, or inconsistencies.
- 3render clear decisions on intricate coding scenarios and document rationale.
- 4apply expertise in E/M levels, modifier -25 usage, time versus MDM considerations, and NCCI rules.
- 5record findings in written feedback and help calibrate other reviewers.
- 6identify coding trends and propose process improvements.
- 7assist in resolving ambiguous coding cases and provide timely guidance.
- 8conduct approximately 10 coding reviews per day and support QA and audit tasks as needed.
Requirements9
- 1AAPC CPC certification is required, CPMA is preferred.
- 210+ years of medical coding experience or prior management of outpatient coding audits at an Academic Medical Center.
- 3experience reviewing and auditing other coders’ work.
- 4deep knowledge of outpatient professional fee coding and auditing principles.
- 5expertise in E/M leveling, modifier -25, time vs. MDM, and NCCI bundling.
- 6ability to make clear, well-supported decisions and apply coding guidelines consistently.
- 7strong written communication and meticulous attention to detail.
- 8comfort giving feedback and helping calibrate fellow reviewers.
- 9experience with QA programs, gold-set reviews, or AI/ML data validation is a plus.
Who Should Apply
The ideal candidate brings extensive outpatient coding expertise within an Academic Medical Center and can deliver precise, well-supported audit decisions. They should be comfortable reviewing peers’ work, articulating feedback clearly, and contributing to QA activities. This role isn’t the best fit for someone without CPC certification or limited experience in outpatient coding audits in academic settings. Common reasons for a lower fit include insufficient hands-on experience with E/M leveling and NCCI rules, or a track record lacking formal QA or mentorship duties.
Salary Insight
Pay range is $30 - $40 per hour. Compensation will be discussed further as part of the interview process.
Location
Required Skills
Application Tip
Highlight specific CPC certification status and concrete audits you led in an academic medical center, including examples of E/M level determinations and NCCI decisions, to demonstrate readiness for daily ten-review workloads.
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