Remote | Medical Auditor — $30–$40/hour

We are sharing a specialised consulting opportunity for experienced Medical Auditors with strong expertise in outpatient professional fee coding, coding audits, academic medical center workflows, audit-program management, and coding quality assurance to contribute to an advanced AI training and medical-coding evaluation project.

Selected professionals will review outpatient professional fee coding, audit other coders' work, resolve complex coding cases, identify recurring quality issues, and provide clear written feedback grounded in professional coding standards. The work is particularly suited to experienced coding auditors with deep familiarity with E/M services, modifier usage, NCCI edits, and academic medical center environments. No prior experience in AI is required.

Key Responsibilities

Outpatient Professional Fee Coding Audits

• Review outpatient professional fee coding for accuracy and compliance
• Audit coding decisions against applicable documentation and coding standards
• Identify incorrect, incomplete, or inconsistent coding
• Apply coding guidance consistently across varied clinical scenarios
• Maintain a high standard of accuracy across repeated reviews

Coder Review & Quality Assurance

• Review the work of other medical coders
• Identify errors, gaps, and recurring quality issues
• Provide clear and actionable written feedback
• Support calibration and consistency across reviewers
• Contribute to broader coding quality-assurance activities

Complex Coding Decisions

• Evaluate difficult or ambiguous coding cases
• Make clear and well-supported determinations
• Apply professional judgement where documentation or coding circumstances are complex
• Clarify appropriate approaches for borderline scenarios
• Document reasoning so decisions can be understood and applied consistently

E/M, Modifier & NCCI Expertise

• Apply expertise in Evaluation and Management level selection
• Review appropriate use of modifier -25
• Assess time-based versus Medical Decision Making-based coding
• Evaluate NCCI bundling considerations
• Identify coding issues affecting reimbursement, compliance, or documentation quality

Audit Findings & Feedback

• Document audit findings clearly and precisely
• Explain why coding decisions are correct or require revision
• Provide structured feedback that supports reviewer improvement
• Identify patterns across audited cases
• Recommend practical improvements to coding and audit processes

Audit Programme Support

• Support coding audit and quality-review workflows
• Contribute to audit-program consistency and operational effectiveness
• Help identify trends that warrant broader education or process changes
• Participate in gold-set reviews or reviewer calibration where needed
• Support AI/ML data-validation workflows where relevant

Ideal Profile

• AAPC CPC certification
• CPMA certification is strongly preferred
• 10+ years of medical coding experience, or experience managing outpatient professional fee coding audits within an Academic Medical Center
• Strong experience auditing other coders' work
• Deep knowledge of outpatient professional fee coding
• Strong understanding of E/M leveling
• Strong understanding of modifier -25
• Familiarity with time-based versus MDM-based coding
• Strong knowledge of NCCI bundling rules
• Ability to make clear and well-supported coding decisions
• Strong written communication skills
• Exceptional attention to detail and consistency
• Comfortable providing reviewer feedback and participating in calibration
• Experience with QA programmes, gold-set reviews, or AI/ML data validation is advantageous
• No prior AI-training or model-evaluation experience is required

Engagement Details

• Independent contractor engagement
• Fully remote
• Compensation: $30–$40/hour
• Expected review volume is approximately 10 reviews per day
• Work will involve outpatient professional fee coding audits, coder-review QA, complex coding decisions, feedback documentation, and audit-program support
• Strong experience with E/M leveling, modifier -25, time versus MDM, and NCCI bundling is central to this engagement
• Academic medical center audit experience is highly valuable
• Project scope, workload, coding scenarios, and evaluation standards may evolve depending on project requirements
• Work must be completed without using confidential or proprietary information belonging to any employer, client, institution, patient, or other third party

About the Platform

This opportunity is available through 24-MAG LLC. We connect experienced professionals with remote consulting opportunities across technical, evaluation, and project-based workstreams.

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