Medical Auditor

Role Title: Medical Auditor

Role Type: Contractor

Location: Remote

The company is engaging Medical Auditors to contribute specialized expertise to a customer’s project within the academic medical center landscape. In this role, you'll apply your expertise to help train next-generation AI systems. Your work will shape how models learn, reason, and perform through high-quality, real-world input. No prior experience in AI is required — your domain knowledge is what matters. This opportunity is ideal for experienced professionals with a proven track record in outpatient professional fee coding and audit program oversight, especially within academic medical centers.

Scope of Work

1. Review and audit outpatient professional fee coding for accuracy and compliance.
2. Review other coders’ work and identify errors, gaps, or inconsistencies.
3. Make clear and consistent decisions on complex coding cases.
4. Apply expertise in E/M leveling, modifier -25, time vs. MDM, and NCCI bundling.
5. Document findings and provide clear written feedback.
6. Identify coding trends and recommend improvements.
7. Help clarify difficult or ambiguous coding cases.
8. Provide timely feedback and complete approximately 10 reviews per day.
9. Support quality assurance and audit activities as needed.

Preferred Qualifications

1. AAPC CPC certification; CPMA preferred.
2. 10+ years of medical coding experience, or experience managing outpatient professional fee coding audits at an Academic Medical Center.
3. Experience reviewing and auditing other coders’ work.
4. Strong knowledge of outpatient professional fee coding and auditing.
5. Strong understanding of E/M leveling, modifier -25, time vs. MDM, and NCCI bundling.
6. Able to make clear, well-supported decisions and apply guidelines consistently.
7. Strong written communication and attention to detail.
8. Comfortable providing feedback and helping calibrate other reviewers.
9. Experience with QA programs, gold-set reviews, or AI/ML data validation is a plus.