Medical Coding Auditor (Outpatient) in New York at Jobgether

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Medical Coding Auditor (Outpatient) based in the United States.

This remote role is an opportunity for an experienced medical coding professional to apply clinical knowledge and coding expertise to outpatient medical records.
You will review documentation, extract relevant clinical information, and ensure accurate assignment of ICD-10-CM and CPT codes.
The position plays an important role in maintaining coding accuracy, supporting appropriate claims outcomes, and upholding healthcare coding standards.
You will work independently in a production-focused environment where attention to detail and sound judgment are essential.
The role also offers exposure to claims interpretation, auditing, appeals, financial recovery, and process-driven healthcare operations.
Success requires strong knowledge of CMS requirements, NCDs, LCDs, NCCI edits, and established outpatient coding guidelines.
You will collaborate within a structured, metrics-driven environment while managing multiple priorities and maintaining high-quality work.

• Review outpatient medical records and extract relevant clinical information to determine accurate procedural and diagnostic coding.
• Assign and validate appropriate medical codes, including ICD-10-CM and CPT, in accordance with applicable coding conventions and standards.
• Conduct detailed outpatient medical record audits to identify coding discrepancies, documentation issues, and opportunities for correction.
• Apply knowledge of NCDs, LCDs, CMS Manuals, NCCI Edits, and other applicable coding guidelines when evaluating records and claims.
• Read and interpret claims information to assess coding accuracy and support appropriate claims outcomes.
• Exercise independent judgment and discretion when determining the appropriate course of action for complex or varied audit findings.
• Manage multiple assignments and priorities in a production-based, metric-driven environment while maintaining accuracy and productivity.
• Document audit findings clearly and communicate relevant information through strong written and verbal communication.
• Support appeals, disputes, financial recovery, and other auditing activities when required.
• Use coding, claims, and operational systems to research and complete audit assignments efficiently.
• Maintain confidentiality and handle protected health information in accordance with applicable privacy and security requirements.
• Contribute to a collaborative, quality-focused environment while working independently and meeting established performance expectations.

• Active CPC, COC, CCS, RHIA, or RHIT certification with at least 3 years of post-certification experience.
• Minimum of 2 years of experience performing outpatient medical record audits, with demonstrated knowledge of outpatient coding conventions and standards.
• Strong working knowledge of NCDs, LCDs, CMS Manuals, NCCI Edits, and applicable coding guidelines.
• Demonstrated ability to exercise sound judgment, discretion, and independent decision-making when reviewing sensitive or complex information.
• Strong attention to detail and the ability to identify coding discrepancies while maintaining consistent quality.
• Ability to work independently, manage workload effectively, and prioritize multiple assignments in a production-oriented environment.
• Strong analytical, organizational, time-management, written, and verbal communication skills.
• Working knowledge of Microsoft Office applications, particularly Word and Excel.
• Preferred experience includes 5+ years of coding experience and at least 3 years of experience reading and interpreting claims.
• Experience with outpatient facility auditing, 3M Coder, CRM/SRO, Pareo, or MOAT is advantageous.
• Experience with appeals and disputes auditing, financial recovery, or fast-paced, metric-driven operations is a plus.
• Advanced or specialty coding certifications are preferred.
• Ability to work standard business hours Monday through Friday, with daily start times between 6:00 AM and 9:00 AM EST, regardless of home time zone.

• Salary: $59,300–$80,900 per year, with compensation varying based on location, skills, experience, education, certifications, and other job-related factors.
• Bonus: Eligibility for a performance-based bonus incentive plan.
• Healthcare: Medical, dental, and vision coverage.
• Retirement: 401(k) retirement savings plan.
• Paid time off: Paid time off, personal and company holidays, and paid parental and caregiver leave.
• Insurance: Short-term and long-term disability coverage and life insurance.
• Remote work: Fully remote position within the United States, with flexibility within established business-hour requirements.
• Home-office support: Telephone equipment appropriate to business needs and potential bi-weekly internet expense support for eligible employees in California, Illinois, Montana, and South Dakota.
• Work environment: Dedicated home workspace required to protect confidential member information, with reliable internet service.
• Schedule: Full-time, 40 hours per week, generally Monday through Friday.
• Travel: Occasional travel for training or meetings may be required.