Remote | Medical Auditor — $30–$40/hour
About The Position
24-MAG LLC is seeking experienced Medical Auditors for a specialized, fully remote independent-contractor consulting engagement supporting an AI training and medical-coding evaluation project. The work focuses on outpatient professional fee coding audits, coder-review quality assurance, complex coding decisions, feedback documentation, and audit-program support. No prior AI-training or model-evaluation experience is required. The selected professional will audit coding for accuracy, compliance, and documentation support; review other coders’ work; assess complex or ambiguous cases; and provide structured, defensible feedback grounded in professional coding standards. The role also supports calibration, gold-set review, quality-assurance workflows, and relevant AI/ML data-validation activities. Expected review volume is approximately 10 reviews per day. Project scope, workload, coding scenarios, and evaluation standards may evolve with project requirements. Work must not use confidential or proprietary information belonging to an employer, client, institution, patient, or other third party.
Requirements
- AAPC CPC certification.
- At least 10 years of medical coding experience, or experience managing outpatient professional fee coding audits within an Academic Medical Center.
- Strong experience auditing other coders’ work.
- Deep knowledge of outpatient professional fee coding.
- Strong understanding of E/M leveling, modifier -25, time versus MDM coding, and NCCI bundling.
- Ability to make clear, defensible coding decisions in complex cases.
- Strong written communication and exceptional attention to detail.
- Comfort providing reviewer feedback and participating in calibration.
- Work must be completed without using confidential or proprietary information belonging to any employer, client, institution, patient, or other third party.
Nice To Haves
- CPMA certification is strongly preferred.
- Experience with QA programmes, gold-set reviews, or AI/ML data validation.
- Academic medical center audit experience is highly valuable.
Responsibilities
- Audit outpatient professional fee coding for accuracy, compliance, and documentation support.
- Review other coders’ work and identify incorrect, incomplete, or inconsistent coding.
- Evaluate complex or ambiguous cases and document well-supported determinations.
- Apply coding guidance consistently across varied clinical scenarios.
- Identify recurring issues affecting coding quality, reimbursement, or compliance.
- Apply expertise in Evaluation & Management (E/M) level selection.
- Review modifier -25 usage and related documentation requirements.
- Assess time-based versus Medical Decision Making-based coding.
- Evaluate NCCI bundling considerations.
- Provide clear rationale for coding decisions and required corrections.
- Document audit findings and provide actionable reviewer feedback.
- Support calibration, gold-set review, and quality-assurance workflows.
- Identify trends requiring broader education or process improvement.
- Contribute to audit-program consistency and operational effectiveness.
- Support AI/ML data-validation workflows where relevant.
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What This Job Offers
Career Level
Senior
Education Level
No Education Listed
