Senior Consultant: Profee Auditor Quality and Education-PRN

UASI
United States
Remote

Who this role is best for

A natural match if you have 3-5 years of profee coding and auditing experience in a multi-specialty setting.

Best fit for

  • Candidates with 3-5 years of multi-specialty profee coding and auditing experience
    — “Minimum of 3-5 years of hands-on professional fee coding and medical record auditing in a multi-specialty or hospital-affiliated setting”
  • Professionals comfortable with independent work and adapting to changing priorities
    — “able to work independently while adapting to changing priorities”
  • HIM experts with strong communication and coaching abilities
    — “the ability to clearly and confidently communicate audit findings, coding rationale, education, and constructive feedback to coders, auditors, and leadership”

Things to consider

  • Certification is mandatory, and must be from AHIMA or AAPC
    — “Active AHIMA or AAPC certification, i.e., CPC, CPMA, CCS-P, or COC”
  • The role involves coaching and providing feedback, not just auditing
    — “translate audit findings and identified trends into clear, actionable education and provide individualized feedback and one-on-one coaching”

How to stand out

  • Highlight experience with multiple specialties and familiarity with EHR systems like EPIC or Cerner
    — “Experience across multiple medical specialties, including Emergency Department, Hospitalist, Primary Care, ENT, Nephrology, Urology, Cardiology, Thoracic, Neurology, Obstetrics and Gynecology, Behavioral Health, Ophthalmology, Endocrinology, etc.”
  • Demonstrate skills in interpreting coding guidelines and regulatory references
    — “Ability to independently research complex coding scenarios, interpret authoritative coding guidance, i.e. Official Coding Guidelines, Medicare/Medicaid Claims Processing Manual, OIG guidance, LCD/NCD documents and transmittals”
  • Emphasize your experience with automated auditing tools and secure file transfer
    — “familiarity with EHR systems (e.g. EPIC, Cerner), navigating automated auditing tools, and the ability to transfer files in a secure manner in compliance with HIPAA policies”
Pace · Fast PacedCollaboration · LowAutonomy · HighDecision Impact · Individual

Derived from job-description analysis by Serendipath's career intelligence engine.

What success looks like

  • active AHIMA or AAPC certification
  • 3-5 years of hands-on professional fee coding and medical record auditing
Typical background
HIM professional with auditing experience

Skills & requirements

Required

Medical CodingAuditingIcd-10-cmCPTHcpcsE/M LevelingProfessional Fee CodingMedical Record AuditingEHR Systems

Preferred

Project ManagementTeam Leadership

Stack & domain

Ahima Or AAPC CertificationIcd-10-cm Diagnosis CodingCPTHcpcsModifiersE/M LevelingProcedural CodingProfessional Coding GuidelinesCPT Guidelines And ConventionsCMS Regulatory RequirementsNCCI EditsEHR Systems (e.g. Epic, Cerner)Hipaa PoliciesFlexibilityDetail-orientedQuality-consciousAbility To Work IndependentlyStrong Analytical And Critical-thinking SkillsAbility To Manage Multiple Assignments And DeadlinesStrong Organizational And Time-management SkillsAbility To Prioritize Competing ResponsibilitiesAbility To Meet Established DeadlinesMaintain Expected Quality And Productivity StandardsAbility To Remain Impartial And ObjectiveCPCCPMACcs-pCOCHealthcareMedical Records Auditing

About the role

Original posting from UASI via Greenhouse

Elevate your expertise! Join UASI today and work with the top HIM experts in the industry. Senior Consultant Auditor positions at UASI allow HIM professionals to have the best of both worlds: a challenging opportunity to utilize and enhance current auditing/coding skills and the convenience of working from home.

We are currently seeking an experienced Profee Coding Auditor to perform coding audits on a variety of professional fee (profee) medical records.  The ideal candidate will be flexible, detail-oriented, quality-conscious, and able to work independently while adapting to changing priorities. The individual must demonstrate strong analytical and critical-thinking skills and the ability to manage multiple assignments and deadlines in a fast-paced, quality-driven environment. Additional qualifications include:

Active AHIMA or AAPC certification, i.e., CPC, CPMA, CCS-P, or COC

Minimum of 3-5 years of hands-on professional fee coding and medical record auditing in a multi-specialty or hospital-affiliated setting

Experience across multiple medical specialties, including Emergency Department, Hospitalist, Primary Care, ENT, Nephrology, Urology, Cardiology, Thoracic, Neurology, Obstetrics and Gynecology, Behavioral Health, Ophthalmology, Endocrinology, etc.

Advanced knowledge and demonstrated auditing experience across the full range of professional coding, including ICD-10-CM diagnosis coding, CPT, HCPCS, modifiers, E/M leveling, and procedural coding.

Strong knowledge of professional coding guidelines, CPT guidelines and conventions, CMS regulatory requirements, NCCI edits, and other applicable profee coding and billing requirements

Ability to independently research complex coding scenarios, interpret authoritative coding guidance, i.e. Official Coding Guidelines, Medicare/Medicaid Claims Processing Manual, OIG guidance, LCD/NCD documents and transmittals, and support audit findings with appropriate coding guidelines and regulatory references

Ability to translate audit findings and identified trends into clear, actionable education and provide individualized feedback and one-on-one coaching to internal coders and auditors, supporting ongoing quality improvement

Experience participating in or supporting peer review, audit-the-auditor, calibration, and other quality assurance activities to promote consistency, accuracy, and standardization.

Strong computer skills including familiarity with EHR systems (e.g. EPIC, Cerner), navigating automated auditing tools, and the ability to transfer files in a secure manner in compliance with HIPAA policies

Excellent verbal and written communication skills, including the ability to clearly and confidently communicate audit findings, coding rationale, education, and constructive feedback to coders, auditors, and leadership

Strong organizational and time-management skills with the ability to prioritize competing responsibilities, meet established deadlines, and maintain expected quality and productivity standards

The ability to remain impartial and objective in finalizing and presenting audit findings

We also recognize that HIM professionals are our greatest asset and in return for your talents, we offer a dynamic work environment, career growth and development, strong leadership and TOP PAY! Additional benefits include:

Medical, Dental, Vision and Life Insurance

Short/ long-term disability, PTO, 401(K), referral bonuses

Training opportunities, yearly educational allowances and continuing education programs

Dedicated support team for guidance and mentoring

UASI's unique approach to employee appreciation which include: birthday recognition, holiday gift selections, years of service awards, and quality bonus programs

Source: UASI careers (Greenhouse)

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