Sr. Profee Coding Auditor
Insight Global is seeking a Senior Profee Coding Auditor to support a healthcare consulting organization that partners with providers nationwide to improve coding accuracy, compliance, and revenue integrity through auditing and education services. This is a direct-placement, fully remote engagement that has shift flexibility. This individual will perform physician-side (profee) coding audits within EMR systems, ensuring compliance with CMS, OIG, and industry standards. This is a high-level, production-driven consulting role requiring strong critical thinking, independent decision-making, and the ability to clearly explain audit findings and rationale to clients. The ideal candidate has extensive experience across multi-specialty profee coding and auditing and can confidently operate in a fast-paced, autonomous environment. The annual salary for this role ranges from 85k-93k depending on the candidates' years of experience. KEY RESPONSIBILITIES:
- Perform profee coding audits (CPT, ICD-10, HCPCS) in EMR systems to ensure accuracy and compliance
- Evaluate documentation and identify coding errors, compliance risks, and documentation gaps
- Develop detailed audit reports with clear rationale and supporting references
- Apply CMS, OIG, and coding guidelines to make independent compliance decisions
- Respond to client inquiries and provide subject matter expertise on coding and compliance issues
- Research coding scenarios and draft responses to complex client questions
- Collaborate with internal team members and participate in biweekly team meetings
MUST HAVES:
- 5+ years of profee (professional fee) coding and/or auditing experience
- Strong expertise in: CPT coding and E/M leveling, Modifiers and CCI edits, and Multi-specialty physician coding (beyond E&M only)
- Deep understanding of documentation and compliance standards (CMS, OIG, AMA)
- Active certification required: CPC or CCS (non-negotiable)
- Proven ability to: Think critically and make independent decisions; Clearly explain and defend coding recommendations
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