Senior Consultant: Profee Auditor Quality and Education

The role

This person will perform coding audits on a variety of professional fee medical records. They will translate audit findings into actionable education and provide coaching to internal coders and auditors.

What you will do

• Perform coding audits on a variety of professional fee medical records
• Research complex coding scenarios and interpret authoritative coding guidance
• Support audit findings with appropriate coding guidelines and regulatory references
• Translate audit findings and identified trends into clear, actionable education
• Provide individualized feedback and one-on-one coaching to internal coders and auditors
• Participate in or support peer review, audit-the-auditor, calibration, and other quality assurance activities
• Communicate audit findings, coding rationale, education, and constructive feedback to coders, auditors, and leadership
• Prioritize competing responsibilities to meet deadlines and maintain quality and productivity standards
• Remain impartial and objective in finalizing and presenting audit findings

Required qualifications

• 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, Behavio
• 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
• 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 po
• Excellent verbal and written communication skills
• Strong organizational and time-management skills

Benefits

• Medical, Dental, Vision and Life Insurance
• Short/ long-term disability
• PTO
• 401(K)
• referral bonuses
• Training opportunities
• yearly educational allowances
• continuing education programs
• Dedicated support team for guidance and mentoring
• birthday recognition
• holiday gift selections
• years of service awards

About the company

UASI works with the top HIM experts in the industry.