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Senior Consultant: Profee Auditor Quality and Education-PRN

1 day, 7 hours ago
Anywhere
Full-time
Mid Level
Manual QA Tester
Quality Assurance and Testing
HIPAA
Apply Now
UASI Solutions

UASI Solutions

UASI Solutions is a top provider of revenue cycle solutions for healthcare facilities, offering coding services and Health Information Management solutions with a focus on accuracy and efficiency.

Diversified Financial Services
251-1K
Founded 1984
View All Jobs 3

Description

  • Perform coding audits of professional-fee medical records across multiple specialties.
  • Evaluate ICD-10-CM, CPT, HCPCS, modifiers, E/M leveling, and procedural coding.
  • Research complex coding scenarios and support audit findings with authoritative guidelines and regulatory references.
  • Translate audit findings and trends into education, individualized feedback, and one-on-one coaching.
  • Participate in peer review, audit-the-auditor, calibration, and other quality-assurance activities.
  • Manage multiple assignments, competing priorities, deadlines, and productivity standards independently.
  • Communicate coding rationale and audit results clearly to coders, auditors, and leadership.
  • Use EHR systems, automated auditing tools, and secure file-transfer processes in compliance with HIPAA.
  • Maintain impartiality and objectivity when finalizing and presenting audit findings.

Requirements

  • Active AHIMA or AAPC certification, such as CPC, CPMA, CCS-P, or COC.
  • 3–5 years of hands-on professional-fee coding and medical-record auditing experience.
  • Experience in a multispecialty or hospital-affiliated setting.
  • Experience auditing across specialties such as emergency medicine, hospitalist care, primary care, cardiology, neurology, obstetrics and gynecology, and behavioral health.
  • Advanced knowledge of professional coding, CPT guidelines, CMS requirements, NCCI edits, and profee billing regulations.
  • Ability to interpret Official Coding Guidelines, Medicare/Medicaid Claims Processing Manuals, OIG guidance, LCD/NCD documents, and transmittals.
  • Strong analytical, critical-thinking, communication, organizational, and time-management skills.
  • Familiarity with EHR systems such as EPIC or Cerner and automated auditing tools.
  • Ability to work independently, adapt to changing priorities, and maintain quality and productivity standards.

Benefits

  • Remote work-from-home arrangement.
  • Medical, dental, vision, and life insurance.
  • Short- and long-term disability, PTO, 401(k), and referral bonuses.
  • Training opportunities, annual educational allowances, and continuing education programs.
  • Dedicated support team for guidance and mentoring.
  • Birthday recognition, holiday gift selections, years-of-service awards, and quality bonus programs.
  • Career growth and development opportunities.

Interested in this position?

Apply directly on the company website

Apply Now

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