Medical Auditor

Medical Auditor

Role Type: Contractor

Location: Remote

Scope of Work

Conduct detailed reviews and audits of outpatient professional fee coding records for accuracy and compliance.
Identify trends, gaps, and potential risks in coding practices, providing actionable recommendations for quality improvement.
Apply comprehensive knowledge of academic medical center protocols to evaluate audit findings and ensure adherence to best practices.
Document findings clearly and provide written narratives that enhance model training data for AI development.
Contribute high-quality feedback on complex coding and auditing scenarios to support AI learning objectives.
Engage in collaborative discussions to clarify ambiguous or nuanced coding and documentation cases.
Support ongoing audit program management initiatives as needed, leveraging extensive experience in similar environments.

Preferred Qualifications

Minimum 10 years' experience in medical coding, with a focus on outpatient professional fee coding and auditing.
Direct experience managing or conducting audits at academic medical centers.
Demonstrated history of consistent high performance and accuracy in coding and audit review assignments.
In-depth understanding of medical coding guidelines, compliance regulations, and audit methodologies.
Exceptional written and verbal communication skills, with the ability to convey complex findings clearly.
Experience delivering insightful, actionable recommendations based on audit data.
Knowledge of audit program management and familiarity with the unique challenges of academic environments.