[Hiring] Lead Professional Fee Coding Auditor @Managed Resources

Role Description

The primary responsibilities of the Lead Professional Fee Coding Auditor comprise of auditing medical records to determine accurate professional fee codes and completing formal audit reports. Additional duties under the direct supervision of the Director of Audit and Education will include audit client project oversight and quality assurance of other auditors on the team.

Why This Role Matters:

• Plays a critical role in strengthening internal operations.
• Provides operational and technical leadership for professional fee audit activities.
• Translates audit findings into actionable improvements that strengthen coding accuracy, compliance, revenue integrity, and workflow efficiency.

What You’ll Gain:

• Flexibility of a remote work environment.
• Visibility and access to leadership.
• Opportunity to contribute ideas and influence change.
• Professional development and career growth opportunities.
• Meaningful work supporting healthcare organizations nationwide.
• A collaborative culture that values employee success, recognition, and work-life balance.

What You’ll Do:

• Perform multi-specialty provider and coder audits by reviewing medical record documentation compared to selected professional fee codes.
• Code review includes E/M, CPT, HCPCS, ICD-10-CM and modifiers.
• Review of medical records may include office visits, hospital visits, minor and majority surgeries and diagnostic testing.
• Accurately enter data into the audit software and/or Audit Excel reports.
• Compose audit findings and recommendations comments.
• Evaluate the overall quality of physician documentation for quality improvement measures.
• Perform accurate audits using applicable coding guidelines and client protocols.
• Report findings and questions from audit staff to the Supervisor or Manager.
• Research coding guidelines and provide updates to audit team and Supervisor.
• Perform quality assurance reviews on team members to ensure accurate coding as assigned by the Supervisor.
• Communicate directly with Supervisor of Professional Audit and Education for client updates, assignments, and client deliverables.
• Communicate with audit team to assist with training, questions, work volumes, project updates and due dates.
• Communicate with client as needed and/or requested by the Supervisor.
• Assist with project tracking.
• Assist with Audit report and Executive Summary report writing.
• Track and enter time accurately and timely into our timekeeping system.
• Comply with policies regarding the use and disclosure of protected health information.
• Ensure compliance with federal and state laws, regulations, and standards related to health information and coding principles.
• Other duties as assigned.

Qualifications

• Must have one of the following current credentials from AAPC or AHIMA: CPC or CCS-P. CPMA a plus.
• A minimum of 5 years’ experience required abstracting CPT, E&M, HCPCS and ICD-10-CM codes from provider documentation.
• A minimum of 5 years’ experience performing professional fee formal audits that include accurate coding, roll up trends and recommendations and written reports.
• A minimum of 1-2 years' recent experience as a Lead or performing similar duties.
• Requires advanced multispecialty coding knowledge in at least 10 medical and surgical specialties.
• Extensive knowledge of medical terminology.
• Experience in researching and applying coding rules and regulations.
• Must have experience with data entry of codes into a database and/or software tool.
• Proficiency in Microsoft Excel, Word, and EMR (Electronic Medical Record) systems including Epic, Cerner, and others.
• Excellent oral and written communication skills.
• Have a positive, respectful attitude.

Benefits

• Medical, Dental, and Vision Insurance.
• Phone and Internet Stipend.
• Company-Paid Life Insurance.
• 401(k) Retirement Plan with Company Match.
• Paid Time Off.
• Seven Company-Observed Holidays.
• Two Floating Holidays for Personal Observance.
• Professional Development Opportunities.
• Employee Recognition Programs.
• Remote Work Environment.