Medical Coding Auditor (Outpatient)

About This Opportunity

We are representing a confidential healthcare organization seeking a Medical Coding Auditor (Outpatient) to join their quality assurance team. This is a fully remote position based in the United States, offering the flexibility to work from home while contributing to critical coding accuracy and compliance efforts.

In this role, you will extract clinical information from diverse medical records and assign appropriate procedural terminology and medical codes (ICD-10-CM, CPT) to patient documentation. Your work will require interpretation skills and independent judgment to determine the most appropriate courses of action across varied assignments.

Responsibilities

• Audit outpatient medical records for coding accuracy and compliance with industry standards
• Apply knowledge of ICD-10-CM and CPT coding systems to ensure proper documentation
• Review and interpret National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), CMS Manual guidance, and NCCI Edits
• Exercise sound judgment in handling and disseminating sensitive information in accordance with HIPAA requirements
• Work independently in a production-based environment while managing multiple priorities
• Maintain strong attention to detail across all audit activities
• Communicate findings clearly through written and verbal channels
• Meet productivity metrics and quality standards

What We're Looking For

Required Qualifications:

• CPC, COC, CCS, RHIA, or RHIT certification with a minimum of 3 years post-certification experience
• Minimum of 2 years of outpatient medical record auditing experience
• Strong knowledge of outpatient coding conventions and standards
• Thorough understanding of NCD/LCDs, CMS Manual, NCCI Edits, and coding guidelines
• Proven ability to work independently and manage workload effectively
• Strong analytical, organizational, and time management skills
• Excellent written and verbal communication abilities
• Working knowledge of Microsoft Office (Word, Excel)
• Comfortable in a production-based, metric-driven work environment
• Reliable internet connection (minimum 25 Mbps download, 10 Mbps upload)
• Dedicated workspace to protect PHI and maintain HIPAA compliance

Preferred Qualifications:

• 5+ years prior coding experience
• Minimum of 3 years reading and interpreting claims
• Outpatient facility auditing experience
• Experience with 3M Coder software
• Experience with CRM/SRO, Pareo, or MOAT systems
• Prior appeals and/or disputes auditing experience
• Background in financial recovery
• Advanced and/or specialty coding certifications

Schedule: Monday–Friday, 8 hours/day. Start times between 6:00 AM–9:00 AM EST regardless of home time zone. Some schedule flexibility may be available after initial training period. Occasional travel for training or meetings may be required.

How We Work With You

Our talent team at Get A Job.ai partners with leading healthcare organizations to identify exceptional coding and auditing professionals. When you apply through our platform, here's what happens:

• A dedicated recruiter from Get A Job.ai will review your application and conduct an initial screening
• If you're a strong match, we'll coordinate interviews which may include pre-recorded voice or SMS text interviews to accommodate your schedule
• We will submit qualified candidates directly to our client for final interviews
• Please do not contact the employer directly—all communication flows through Get A Job.ai to ensure a smooth, professional process

Pay

This position offers competitive compensation and is eligible for bonus incentives based on company and individual performance. Specific pay details will be discussed during the screening process.

Equal Employment Opportunity: Get A Job.ai is committed to creating a diverse and inclusive environment. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other protected characteristic. All employment decisions are based on qualifications, merit, and business needs.