Certified Professional Medical Auditor
WFA Digital Insight
The demand for skilled medical auditors has surged in recent years, with the medical billing and coding market expected to grow significantly by 2028. As healthcare providers shift towards value-based care, the need for professionals who can ensure accuracy and compliance in medical coding has never been more pressing. KinwellHealth, a company dedicated to personalized and holistic care, is now hiring a Certified Professional Medical Auditor to join their team. With a strong focus on employee growth and collaborative innovation, KinwellHealth offers a unique work environment for professionals looking to make a real impact. Before applying, candidates should be aware of the importance of attention to detail, sound knowledge of outpatient coding guidelines, and effective communication skills in this role.
Job Description
About the Role
The Certified Professional Medical Auditor plays a critical role in ensuring the accuracy, compliance, and integrity of outpatient coding across the enterprise. This position conducts routine enterprise-wide audits and targeted spot checks to evaluate coding quality, identify trends, and mitigate risk. As a key member of the team, the Certified Professional Medical Auditor will work closely with coding teams, compliance, and primary care providers to support revenue cycle optimization and clinical documentation excellence.The ideal candidate will demonstrate strong attention to detail, sound knowledge of outpatient coding guidelines, and the ability to communicate effectively across teams. With a focus on employee growth and collaborative innovation, KinwellHealth offers a unique work environment for professionals looking to make a real impact.
As a remote position, the Certified Professional Medical Auditor will be required to live in the United States, with a preference for those living in Washington state or Texas. The successful candidate will be part of a team that values diversity of thought, ideas, and cultures, all focused on the common goal of nurturing the health of those they serve.
What You Will Do
- Conduct enterprise-wide and ad-hoc spot audits of outpatient encounters to assess coding accuracy, completeness, and compliance with regulatory requirements and organizational policies.
- Identify and correct coding errors in Epic and ensure appropriate follow-through on audit findings.
- Submit clear, concise, and compliant queries to clinicians for clarification of documentation as needed.
- Accurately code outpatient encounters in accordance with ICD-10-CM, CPT, HCPCS, and applicable payer guidelines.
- Provide one-on-one and group coding education to clinicians and clinical support teams, based on audit findings and identified learning opportunities.
- Collaborate with clinical, compliance, and revenue cycle departments to support accurate and complete documentation and coding.
- Track and trend audit results to support continuous improvement initiatives and report out to leadership as needed.
- Stay current with coding updates, CMS guidelines, payer policies, and industry best practices.
- Develop and maintain a thorough understanding of KinwellHealth's coding policies and procedures.
- Participate in special projects and perform other duties as assigned.
What We Are Looking For
- Certified Professional Coder (CPC) certification.
- Certified Professional Medical Auditor (CPMA) credential.
- Three years of experience with outpatient coding.
- Strong knowledge of ICD-10-CM, CPT, HCPCS, and outpatient documentation and coding guidelines.
- Experience auditing in Epic or similar EHR system.
- Meticulous attention to detail with a high standard of coding accuracy.
- Collaborative mindset with a proactive approach to problem-solving.
- Comfortable delivering constructive feedback to clinicians and peers.
- Understanding of the role of coding in supporting both clinical care and revenue integrity.
- Adaptable and open to evolving audit needs and process improvements.
- Experience coding for primary care or family/internal medicine.
Nice to Have
- Certified Risk Adjustment Coder (CRC) certification.
- Prior experience conducting provider education or training.
- Working knowledge of MS Office, particularly Excel.
- Familiarity with medical terminology and clinical procedures.
- Experience with data analysis and reporting.
Benefits and Perks
- Competitive salary and benefits package.
- Opportunity to work remotely from the United States.
- Collaborative and dynamic work environment.
- Professional development and growth opportunities.
- Access to cutting-edge technology and tools.
- Comprehensive health insurance and wellness programs.
- Generous paid time off and holiday policy.
- Retirement savings plan with company match.
How to Stand Out
- Ensure your resume and cover letter highlight your experience with outpatient coding and auditing, as well as any relevant certifications such as CPC or CPMA.
- Be prepared to providespecific examples of your coding accuracy and attention to detail during the interview process.
- Familiarize yourself with KinwellHealth's coding policies and procedures to demonstrate your understanding of their specific needs.
- Develop a portfolio that showcases your ability to communicate complex coding concepts to clinicians and other stakeholders.
- Be ready to discuss your experience with Epic or similar EHR systems, and how you have used these systems to improve coding quality and compliance.
- Consider obtaining additional certifications, such as CRC, to increase your competitiveness for the role.
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