Profee Auditing & Education Consultant

The Outpatient and Profee Audit and Education Specialist (“Auditor”) evaluates the assignment of ICD-10, CPT, and HCPCS codes to outpatient and physician practice encounters, performing concurrent and retrospective reviews to validate code accuracy and compliance with federal, state, and payer guidelines. They identify documentation and coding trends and report findings to clients, developing and delivering educational content to coders and providers based on audit results and opportunities for improvement.

Responsibilities include performing complex medical record analyses to validate coded data, evaluating documentation for accuracy and regulatory compliance, identifying trends and compliance risks, preparing detailed audit reports, conducting second-level reviews for correct code assignments, researching compliance inquiries, ensuring patient and client confidentiality, contributing to coding education programs, meeting productivity standards, performing quality assurance reviews with minimum 95% accuracy, timely reporting, maintaining professional credentials, and other duties as assigned.

Knowledge and skills required include recognized credentials from AHIMA or AAPC, experience with telecommuting and electronic medical records, strong analytical and computer skills, teamwork, ability to manage multiple clients and projects independently, high accuracy, and at least 5 years of coding/auditing experience in acute care or clinics.