- Remote, United States
- Remote
- Full-time
- $65K–$75K per year
- 3+ years
Remote Certified Outpatient Auditor responsible for reviewing outpatient claims, ensuring coding accuracy, and identifying reimbursement opportunities.
Compensation
Pay range for this role is: $65k - $75k
Responsibilities
- Audit outpatient claims with a focus on APC groupings, revenue codes, CPT bundling rules, and UB‑04 facility coding requirements.
- Ensure accurate documentation and coding of technical components such as nursing services, equipment use, and place of service.
- Verify that facility charges and resource utilization are coded correctly and independently from provider claims.
- Conduct detailed audits across infusion therapy, surgical services, interventional radiology, and other hospital outpatient service lines.
- Review CPT, APC to validate correct reporting and reimbursement.
Requirements
- Nice to have: advanced knowledge of infusion and injection coding regulations
- Nice to have: retrospective overpayment identification
- Nice to have: experience auditing complex outpatient surgical and interventional radiology cases