Senior Coding Auditor, Itemized Bill Reviewer- Remote

Gainwell Technologies LLC•Any city, OH

33d•$70,000 - $80,000•Remote

About The Position

The Senior Coding Auditor, Itemized Bill Reviewer performs itemized bill review, chart review, and coding validation to ensure billed services were ordered, allowable, and accurately documented in the patient record. The role requires an extensive background in inpatient hospital bill auditing and outpatient facility coding with charge master review. The auditor verifies bill lines against services and procedures performed, coverage, documentation, plan policies, and provider contract terms. They evaluate records for accurate coding, charging, and reimbursement; use proprietary auditing systems to document findings and rationale; and meet management’s productivity and quality standards. The role also involves cross-training across claim types, helping train new Coding Auditors, maintaining coding knowledge and certification through continuing education, and attending training and scheduled meetings. This is a 100% remote position with up to 10% travel. The stated annual pay range is $70,000–$80,000, with the actual base pay potentially varying based on geographic region, internal equity, and job-related knowledge, skills, and experience. Benefits are effective on the first day of employment. Salaried, full-time employees are eligible for a flexible vacation policy, a 401(k) employer match, comprehensive health benefits, educational assistance, and leadership and technical development academies.

Requirements

One or more active professional credentials through AHIMA or AAPC: CPC, COC, CCS, RHIA, or RHIT.
Proficiency in medical record auditing and ICD-10-CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodology.
Strong working knowledge of hospital billing and charging, including UB-04s, itemized bills, revenue codes, CPT/HCPCS codes, and ICD-10 diagnosis and procedure codes.
Proficiency with Microsoft Windows, Outlook, Excel, Word, PowerPoint, internet browsers, and virtual meeting tools such as Microsoft Teams and Zoom.

Nice To Haves

At least 2 years of experience in inpatient hospital bill auditing and outpatient facility coding with charge master review; strongly preferred.

Responsibilities

Verify itemized bill lines accurately reflect services and procedures performed, are covered benefits, were appropriately ordered and documented, and are reimbursed according to plan policies and provider contract terms.
Evaluate documentation for accurate coding, charging, and reimbursement for inpatient hospital and outpatient facility services.
Use proprietary auditing systems proficiently to document audit findings and rationale.
Meet productivity and quality performance standards established by management.
Cross-train to review multiple claim types to help provide a flexible workforce for client needs.
Assist management in training new Coding Auditors through daily monitoring, mentoring, feedback, and education.
Maintain current knowledge of coding guidelines and complete required CEUs to maintain coding certification.
Attend training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.