MedReview Inc. · 21 hours ago
Outpatient Coder Auditor
United States
Full-time
Remote
Mid Level
$100K/yr - $102K/yr
3+ years expMedReview Inc. is a leading authority in payment integrity solutions, dedicated to bringing accuracy and clinical excellence to healthcare. The Outpatient Coder Auditor is responsible for reviewing outpatient medical claims to ensure coding accuracy and compliance, while also identifying trends and potential cost savings opportunities across outpatient facility claims.
Health CareMedicalNon ProfitProfessional Services
Responsibilities
Perform detailed coding audits on outpatient facility claims to validate appropriate CPT/HCPCS, revenue codes, modifiers, and ICD-10 coding in accordance with CMS, NCCI, and payer-specific rules
Evaluate medical record documentation to ensure services are coded, billed, and reimbursed accurately
Identify and analyze payment integrity issues including overpayments, underpayments, and incorrect billing patterns
Collaborate with clinical, data analytics, and payment integrity teams to develop new outpatient claim review concepts and audit strategies
Provide education and feedback to internal teams or providers based on audit findings
Research and apply current CMS OPPS, APC, and EAPG guidelines to ensure compliant auditing practices
Document audit findings clearly and concisely, maintaining a high standard of accuracy and quality assurance
Contribute to the development and testing of audit tools, rule logic, and automated review concepts to enhance outpatient claim accuracy
Stay current with regulatory updates, coding changes, and payer policy revisions
Qualification
Required
Certified Professional Coder (CPC), Certified Outpatient Coder (COC), or equivalent AHIMA certification (CCS)
3+ years of experience in outpatient facility coding, auditing, or payment integrity
Strong knowledge of CMS OPPS, APC, and EAPG payment methodologies
Proficiency in interpreting medical documentation and applying official coding guidelines
Excellent analytical, organizational, and written communication skills
Preferred
Experience with managed care organizations, commercial payer claim reviews, or payment integrity programs
Familiarity with data analytics tools and claim review platforms
Prior experience in payment integrity, and audit development strongly preferred
Benefits
Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents
401(k) with Employer Match - Join the team and we will invest in your future
Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you’re not feeling well, to observe holidays
Wellness - We care about your well-being. From Commuter Benefits to FSAs we’ve got you covered
Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we’re focused on your growth as a working professional
Company
MedReview Inc.
MedReview is a different type of payment integrity company.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Spencer Young
Chief Executive Officer
Ripal Patel
Chief Financial Officer
Recent News
2025-11-20
2025-08-29
2025-07-23
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