Coding & Documentation Compliance Specialist (CPC/CPMA)

Coding & Documentation Compliance Specialist (CPC/CPMA)

We are seeking an experienced Coding & Documentation Compliance Specialist to strengthen coding accuracy, documentation integrity, and reimbursement compliance within a physician-led healthcare environment. In this remote, independent contractor role, you will ensure that clinical documentation fully supports billed services while identifying opportunities to improve coding practices and revenue integrity. You will conduct prospective code evaluations, retrospective chart audits, and targeted reviews across providers and service lines. Working closely with clinical teams, billing professionals, and medical leadership, you will translate audit findings into practical documentation guidance, workflow improvements, and staff education. You will also contribute to Merit-based Incentive Payment System (MIPS) reporting and quality-measure compliance. This opportunity is ideal for a detail-oriented coding professional with strong Medicare expertise who can combine hands-on auditing with actionable recommendations that support high-quality, compliant patient care.

Accountabilities

• Conduct baseline documentation audits of 1020 charts per billing provider across encounters and deliver detailed findings reports, including error rates by provider and service line.
• Perform ongoing quarterly audits of approximately 10 charts per provider, along with focused reviews of specific service lines as needed.
• Implement 100% pre-bill reviews during new-code rollouts until the error rate falls below 5%.
• Place providers with error rates above 10% on monthly review, providing targeted education and follow-up audits until performance returns below the established threshold.
• Evaluate the appropriateness of unused or underutilized codes within the care model and define the documentation required to support compliant billing.
• Develop clear, practical documentation guidance for clinical staff and billing teams to improve coding consistency and accuracy.
• Support successful MIPS participation by identifying appropriate quality measures and ensuring documentation meets or exceeds applicable requirements.
• Recommend improvements to clinical documentation templates, workflows, and supporting materials to strengthen coding compliance and MIPS performance.
• Identify recurring documentation gaps and translate audit findings into clinician education, workflow enhancements, and sustainable corrective actions.
• Collaborate with medical leadership and relevant operational teams to maintain accurate, defensible, and compliant coding practices.

Requirements:

• Current Certified Professional Coder (CPC) certification through AAPC or Certified Coding SpecialistPhysician-based (CCS-P) certification through AHIMA.
• Certified Professional Medical Auditor (CPMA) certification strongly preferred, or equivalent demonstrated experience conducting medical chart audits.
• At least five years of experience coding outpatient evaluation and management (E/M) services, including direct auditing responsibilities.
• Strong understanding of Medicare billing requirements, particularly telehealth rules and documentation standards.
• Experience supporting MIPS reporting and documenting quality measures in accordance with applicable requirements.
• Strong knowledge of outpatient coding, documentation integrity, coding accuracy, and compliant reimbursement practices.
• Demonstrated ability to identify coding and documentation deficiencies, assess risk, and develop practical corrective recommendations.
• Excellent analytical, organizational, and communication skills, with the ability to explain complex coding requirements clearly to clinicians and billing professionals.
• Must be based in the United States and have substantial experience working with Medicare.
• Experience in obesity medicine, endocrinology, or primary care is an advantage.
• Familiarity with OIG self-disclosure processes or responding to payer audits is desirable.
• Experience developing clinical documentation templates, clinician reference guides, or coding cheat sheets is a plus.
• Ability to work independently, manage ongoing audit cycles, and collaborate effectively with medical leadership and cross-functional teams.

Benefits:

• Work arrangement: Fully remote within the United States.
• Employment type: Independent contractor.
• Workload: Approximately 1520 hours per week, on an ongoing basis.
• Reporting structure: Direct collaboration with and reporting to the Senior Medical Director.
• Professional impact: Help improve coding accuracy, documentation quality, reimbursement integrity, and regulatory compliance.
• Meaningful contribution: Support a healthcare model focused on accessible, evidence-based care and improved long-term patient outcomes.
• Process improvement opportunities: Shape documentation standards, clinical workflows, and audit-driven education initiatives.