Certified Professional Coder, Auditor

Salary Range: $28.00 To $33.00 Hourly The Revenue Cycle Management Auditor is responsible for conducting comprehensive audits across all phases of the revenue cycle to ensure accuracy, compliance, and optimal reimbursement. This role is critical in identifying revenue leakage, reducing denials and strengthening internal controls and staff productivity requirements. The Auditor will evaluate charge capture, coding accuracy, documentation integrity, billing workflows, payment posting, denial follow-up, Appeals, and AR follow-up for RCM, clinical, and provider teams to drive continuous process improvement. *This is a remote role. We are only hiring in the following states: AZ, CA, NM, NV, OR, TX and WA. What you will do: Audit execution & oversight by performing routine and ad hoc audits across the full revenue cycle process, including:  Charge entry and charge capture accuracy  CPT, HCPCS, and ICD-10 coding compliance  Modifier usage  Workers’ compensation billing rules and state-specific fee schedules  Claim submission accuracy and clean claim rates  Payment posting and adjustment accuracy  AR follow-up effectiveness and denial resolution workflows  Conduct pre-bill and post-bill audits to identify trends impacting reimbursement and compliance  Denial & Revenue leakage analysis:  Analyze denial trends across WC, Medicare, and commercial payers  Identify root causes of denials and recommend corrective actions  Quantify revenue impact from:  Coding errors  Missed charges  Underpayments  Inefficient workflows  Ensure adherence to:  CMS guidelines and Medicare billing requirements  NCCI (CCI edits) and payer-specific edits  State Workers’ Compensation regulations  Documentation standards for pain management procedures  Support internal and external audit readiness (RAC, MAC, payer audits).  Reporting & KPI development through audit dashboard  Maintain monthly & quarterly records of all RCM, clinical, and provider audit scores and training requirements  Partner with all BHC teams to develop and deliver targeted education based on audit findings.  Assist in creating and updating SOPs and workflows to reduce errors and improve efficiency  Establish and maintain quality assurance programs across RCM functions  Perform routine QA reviews of staff productivity and accuracy  Recommend automation opportunities and system enhancements  Assumes other responsibilities as appropriate to the position and organizational needs Qualifications: High school diploma or equivalent required; Associate degree preferred  Active coding certification required: CPC, CCS, or equivalent (AAPC or AHIMA)  5+ years of experience in revenue cycle management   3+ years of auditing experience within healthcare billing or coding  Strong experience in pain management  Experience with Medicare and commercial payer guidelines  Ability to work in a fast-paced environment, meet daily deadlines, and collaborate with cross-functional RCM teams  Excellent communication skills with ability to present findings to providers and RCM leadership  Advanced understanding of NCCI edits and payer-specific billing guidelines  Accuracy and attention to detail, analytical thinking and problem solving and high integrity and compliance focus  Advanced proficiency in Microsoft Excel (e.g., formulas, pivot tables) and solid skills in other Microsoft Office applications  Compensation Range: $30.00 to $35.00 Hourly All compensation ranges are posted based on internal equity, job requirements, experience, and geographical locations. Why You'll Love Working Here: Amazing work/life balance Generous Medical, Dental, Vision, and Prescription benefits (PPO & HMO) 401(K) Plan with Employer Matching License & Tuition Reimbursements Paid Time Off Holiday Pay & Floating Holiday Employee Perks and Discount Programs Supportive environment to help you grow and succeed Boomerang Healthcare (BHC) is a multidisciplinary and comprehensive team of experienced, committed healthcare providers that treat pain. Our team of doctors approaches each patient with one goal in mind: to help patients return to normal daily activities. We work with our patients to identify the cause of their pain and create a personalized treatment plan, recognizing that no two patients are alike, and neither is their pain. Our providers create a comprehensive care plan, then monitor, manage and coordinate patient access to health services at BHC.  Boomerang Healthcare strives to be a diverse workforce that reflects, at all job levels, the patients we serve. We are an equal opportunity employer. Boomerang Healthcare is committed to compliance with the American Disabilities Act. If you require reasonable accommodation during the application process or have a question regarding an essential job function, please contact us. Monday-Friday, 8am-5pm 40