Senior Medical Review Coding Appeals Auditor - REMOTE

Jobgether

4d • $65,000 - $73,000 • Remote

About The Position

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Senior Medical Review Coding Appeals Auditor. In this role, you will be pivotal in conducting Appeals reviews and ensuring accuracy in medical coding. Your expertise will support the identification of training opportunities and enhance guideline materials. You will drive quality and efficiency in audit processes while contributing to continuous improvement. Join us to make a meaningful impact in healthcare payment and data accuracy.

Requirements

• CPC, CPC-H, CPC-P, RHIA, RHIT, CCS, or CCS-P certification required.
• 3+ years of direct experience in medical chart review for outpatient.
• 5+ years of relevant auditing experience in medical environments.
• Thorough knowledge of CPT/HCPCs/ICD-9/ICD-10 coding systems.
• Strong knowledge of medical documentation requirements and insurance programs.
• Proficient in analyzing claims data and conducting quality assurance reviews.
• Excellent communication skills, both verbal and written.
• Strong analytical and problem-solving skills.
• Ability to work independently and collaboratively in a remote setting.
• Solid technical aptitude and proficiency with MS Office applications.

Responsibilities

• Perform outpatient coding reviews on medical records to maintain expertise.
• Conduct Appeals reviews on medical audit findings based on new evidence.
• Document Appeals results accurately according to department policies.
• Review audit documentation and conduct research to ensure accuracy.
• Flag patterns of concern for real-time intervention by audit leadership.
• Contribute to the continuous improvement process, suggesting necessary edits.
• Monitor and report on work conducted in accordance with Appeals process.
• Prepare reports for management highlighting data and trends.
• Maintain current knowledge of industry impacts on medical practice.
• Participate in department meetings contributing to team improvement.
• Support training for new staff and provide supplemental training as needed.

Benefits

• Competitive salary range of $65,000 - $73,000.
• Comprehensive medical, dental, and vision insurance.
• 401(k) savings plans with employer matching.
• Paid holidays and annual paid time off.
• Family and parental leave options.
• Remote work flexibility with required high-speed internet access.
• Support for work-life balance initiatives.
• Access to training and professional development resources.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed
• Number of Employees: 11-50 employees