Outpatient Coding QA Auditor

Role will conduct comprehensive quality audits across various medical coding specialties. This role is responsible for assessing coding accuracy, ensuring compliance with official coding guidelines, and providing clear, evidence-based audit findings to support continuous quality improvement in outpatient and specialty coding environments.

Key Responsibilities

• Conduct detailed audits of professional billing (PB) medical coding across multiple specialties.

• Evaluate coding accuracy, documentation integrity, and compliance with official coding guidelines.

• Provide clear audit findings with detailed rationale and supporting references.

• Utilize industry-recognized coding resources, including:
  

• Identify trends, knowledge gaps, and opportunities for coding accuracy improvement.

Qualifications

• Minimum 5 years of outpatient coding experience, with exposure to multiple specialties.

• At least 1 year of coding experience in each specialty in SDS, ED, Oncology

• Strong knowledge of ICD-10-CM, CPT, HCPCS, and official coding guidelines.

• Excellent analytical skills with the ability to provide detailed documentation and references for audit findings.

• Strong written and verbal communication skills.

• High attention to detail and strong ethical standards.