Requirements
- Perform remote audits of primarily outpatient, professional fee, Orthopaedic coding auditing to include Orthopaedic surgery coding, some inpatient professional coding, Physical Therapy, and Occupational Therapy coding auditing, as well
- Review medical documentation for accurate assignment of ICD-10-CM, CPT, and HCPCS codes
- Ensure compliance with CMS, Medicare, Medicaid, commercial payer, and organizational guidelines
- Identify coding trends, risks, and opportunities for improvement
- Prepare audit summaries, reports, and corrective action recommendations
- Provide virtual or in-person education and feedback to coders, physicians, and clinical staff
- Participate in compliance reviews and external audit responses
- Maintain detailed audit documentation and confidentiality standards
- Stay informed on coding updates, payer policy changes, and industry regulations
Required Qualifications
- High school diploma or equivalent required
- 3–5+ years of medical coding and auditing experience
- Strong knowledge of ICD-10-CM, CPT, HCPCS, and medical terminology
- Experience auditing electronic health records remotely
- Familiarity with CMS regulations and payer reimbursement methodologies
- Proficiency with EHR systems, encoder software, Microsoft Office, and remote communication tools
- Strong analytical, organizational, and written communication skills
- Ability to work independently in a remote environment
Preferred Certifications
One or more of the following certifications required:
- AAPC Certified Professional Coder (CPC)
- AAPC Certified Professional Medical Auditor (CPMA)
- AAPC Certified Professional Compliance Officer (CPCO)
- AHIMA Certified Coding Specialist (CCS)
- AHIMA Registered Health Information Administrator (RHIA)
Remote Work Requirements
- Reliable high-speed internet connection
- Secure home office environment compliant with HIPAA standards
- Ability to participate in video meetings and remote collaboration
- Self-directed with strong time-management skills
Compensation
Typical salary depending on certifications, specialty experience, employer, and references.
Benefits May Include
- Remote/work-from-home flexibility
- Health, dental, and vision insurance
- Paid time off and holidays
- Continuing education allowance
- Certification renewal assistance
- 401(k) with employer match
Sample Skills
- Clinical documentation review
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.
