Remote Professional Coding Auditor

Overview

Be inspired. Be valued. Belong . At Emory Healthcare

At Emory Healthcare we fuel your professional journey with better benefits valuable resources ongoing mentorship and leadership programs for all types of jobs and a supportive environment that enables you to reach new heights in your career and be what you want to be . We provide:

• Comprehensive health benefits that start day 1

• Student Loan Repayment Assistance & Reimbursement Programs

• Family-focused benefits

• Wellness incentives

• Ongoing mentorship development leadership programs

• And more

LOCATION:

Remote

This position is remote; however applicants must be physically located and authorized to work in one of the following states: Alabama Arkansas Florida Georgia Illinois Louisiana Michigan New Hamsphire North Carolina Ohio Pennsylavnia South Caroline Tennessee Texas Virginia Wisconsin

Description

This position ensures the accuracy completeness and compliance of medical coding and clinical documentation for professional coding services. The role supports accurate coding practices appropriate reimbursement and regulatory compliance by reviewing patient records and collaborating with healthcare providers coding teams and compliance staff.

RESPONSIBILITIES

Ensures the accuracy completeness and compliance of medical coding and documentation for professional coding services.
Reviews patient records clinical documentation and coded data to identify discrepancies and coding issues.
Works closely with healthcare providers coders and compliance teams to support accurate professional coding practices.
Supports appropriate reimbursement and mitigates compliance risks through detailed coding reviews.
Conducts comprehensive chart reviews to evaluate coding accuracy and documentation quality.
Evaluates provider documentation to ensure appropriate coding and regulatory compliance.
Participates in routine audits to maintain high standards of coding accuracy and compliance.
Provides education and training to healthcare professionals regarding coding standards and documentation improvement.
Analyzes coding data to identify trends opportunities for improvement and compliance risks.
Generates audit reports summarizing findings and recommendations.

AUDIT AND REVIEW

Conducts regular audits of medical coding to verify accuracy completeness and compliance with ICD-10 CPT HCPCS and other coding systems.
Evaluates coding practices against payer guidelines regulatory requirements and internal organizational policies.

COMPLIANCE MONITORING

Ensures adherence to federal and state regulations including CMS guidelines and HIPAA standards.
Identifies discrepancies or violations and recommends corrective actions.

REPORTING AND DOCUMENTATION

Prepares detailed audit reports outlining findings trends and recommendations for improvement.
Documents audit procedures results and issues in a clear and organized manner.

STAY CURRENT

Maintains up-to-date knowledge of coding guidelines healthcare regulations and industry best practices.
Participates in relevant workshops seminars and continuing education programs as required.

MINIMUM QUALIFICATIONS

High school diploma or equivalent required.
Two years of post-secondary education in a business or medical-related field preferred.
Two years of experience in a medical billing or coding office required; medical management experience preferred.
Equivalent combinations of education and experience may be considered.
Coding certification through a nationally recognized organization such as AAPC or AHIMA required (CCS-P CPC RHIA RHIT CCS CPC-H).

Minimum of two years of experience working in a medical billing coding or healthcare revenue cycle environment preferred.
Experience with medical coding auditing or chart review in a healthcare setting preferred.
Familiarity with electronic health record (EHR) systems preferred.

KNOWLEDGE SKILLS AND ABILITIES

Strong knowledge of medical terminology anatomy and coding systems.
Strong written and verbal communication skills.
Thorough understanding of healthcare regulations and compliance standards.
Excellent attention to detail and accuracy in documentation review.
Ability to analyze coding data and identify discrepancies or improvement opportunities.

Additional Details

Emory is an equal opportunity employer and qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability protected veteran status or other characteristics protected by state or federal law.

Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcares Human Resources at . Please note that one weeks advance notice is preferred.

Required Experience:

Unclear Seniority