Coding Compliance Audit & Education Specialist

About This Opportunity

We are representing a confidential healthcare organization seeking a Coding Compliance Audit & Education Specialist to join their compliance team. This fully remote position offers the opportunity to work with healthcare providers across the United States, ensuring adherence to federal coding regulations while providing expert education and consultation.

Responsibilities

• Conduct comprehensive audits (baseline, routine periodic, and focused) comparing medical record documentation to reported CPT/HCPCS and ICD-10-CM codes with consideration of applicable federal and state laws, regulations, and guidelines
• Research, interpret, and communicate federal and state laws and guidelines pertaining to CMS and Medicare
• Serve as an internal expert on coding issues to ensure compliance with state and federal regulations
• Prepare detailed audit reports including summary of findings and actionable recommendations
• Conduct post-audit provider education sessions with individual providers or large provider groups
• Schedule and deliver training sessions with provider offices, individual providers, and groups
• Provide feedback, initial and ongoing education, and technical support regarding proper documentation guidelines, service selection, charge capture, supervision, timely submission, healthcare data accuracy, and coding principles
• Communicate audit findings to providers and track education completion and escalation
• Provide coding assessment, consultation, education, and issue resolution to key stakeholders as requested
• Engage in honest, constructive conversations with providers about compliance, documentation, and code assignment

What We're Looking For

• Required: Certified Professional Coder (CPC) certification
• Required: Certified Professional Medical Auditor (CPMA) certification
• Preferred: 5+ years of audit and provider education experience
• Extensive knowledge of CPT, ICD-10, and HCPCS codes and guidelines
• Experience working with MDAudit and Athena is a plus
• Must comply with all HIPAA rules and regulations
• Excellent communication skills and the ability to work independently
• Ability to interact professionally and effectively with physicians, leaders, staff, and internal teams
• Comfortable conducting difficult conversations regarding compliance matters
• For remote work: minimum internet speed of 5 MBPS download and 3 MBPS upload

How We Work With You

When you apply through Get A Job.ai, our talent team will review your qualifications and conduct an initial screening. If there's a strong match, we'll submit your profile to our client for consideration. Please do not contact the client directly, as all communication should flow through our recruiting team to ensure the best experience for everyone involved.

Pay

Our client offers a competitive compensation package with base salary range of $70,000 to $80,000, plus eligibility for a 15% annual bonus. Benefits include medical, dental, vision, life and pet insurance, 401K, paid time off, and wellness programs. Remote workers are eligible for expense reimbursement to offset home office costs.

Get A Job.ai is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all candidates.