Senior Consultant: Profee Auditor Quality and Education

Elevate your expertise! Join the company today and work with the top HIM experts in the industry. Senior Consultant Auditor positions at the company allow HIM professionals to have the best of both worlds: a challenging opportunity to utilize and enhance current auditing/coding skills and the convenience of working from home.

We are currently seeking an experienced Profee Coding Auditor to perform coding audits on a variety of professional fee (profee) medical records.  The ideal candidate will be flexible, detail-oriented, quality-conscious, and able to work independently while adapting to changing priorities. The individual must demonstrate strong analytical and critical-thinking skills and the ability to manage multiple assignments and deadlines in a fast-paced, quality-driven environment. Additional qualifications include:

• Active AHIMA or AAPC certification, i.e., CPC, CPMA, CCS-P, or COC

• Minimum of 3-5 years of hands-on professional fee coding and medical record auditing in a multi-specialty or hospital-affiliated setting

• Experience across multiple medical specialties, including Emergency Department, Hospitalist, Primary Care, ENT, Nephrology, Urology, Cardiology, Thoracic, Neurology, Obstetrics and Gynecology, Behavioral Health, Ophthalmology, Endocrinology, etc.

• Advanced knowledge and demonstrated auditing experience across the full range of professional coding, including ICD-10-CM diagnosis coding, CPT, HCPCS, modifiers, E/M leveling, and procedural coding.

• Strong knowledge of professional coding guidelines, CPT guidelines and conventions, CMS regulatory requirements, NCCI edits, and other applicable profee coding and billing requirements

• Ability to independently research complex coding scenarios, interpret authoritative coding guidance, i.e. Official Coding Guidelines, Medicare/Medicaid Claims Processing Manual, OIG guidance, LCD/NCD documents and transmittals, and support audit findings with appropriate coding guidelines and regulatory references

• Ability to translate audit findings and identified trends into clear, actionable education and provide individualized feedback and one-on-one coaching to internal coders and auditors, supporting ongoing quality improvement

• Experience participating in or supporting peer review, audit-the-auditor, calibration, and other quality assurance activities to promote consistency, accuracy, and standardization.

• Strong computer skills including familiarity with EHR systems (e.g. EPIC, Cerner), navigating automated auditing tools, and the ability to transfer files in a secure manner in compliance with HIPAA policies

• Excellent verbal and written communication skills, including the ability to clearly and confidently communicate audit findings, coding rationale, education, and constructive feedback to coders, auditors, and leadership

• Strong organizational and time-management skills with the ability to prioritize competing responsibilities, meet established deadlines, and maintain expected quality and productivity standards

• The ability to remain impartial and objective in finalizing and presenting audit findings

We also recognize that HIM professionals are our greatest asset and in return for your talents, we offer a dynamic work environment, career growth and development, strong leadership and TOP PAY! Additional benefits include:

• Medical, Dental, Vision and Life Insurance

• Short/ long-term disability, PTO, 401(K), referral bonuses

• Training opportunities, yearly educational allowances and continuing education programs

• Dedicated support team for guidance and mentoring

• the company's unique approach to employee appreciation which include: birthday recognition, holiday gift selections, years of service awards, and quality bonus programs