Outpatient Coding Auditor

Position Description

Job Summary

The Outpatient Coding Auditor is a member of the CGI Healthcare Payment Integrity Team with responsibility for rendering appropriate, well supported, and thoroughly documented decisions which may result in the identification of improper payments on paid claims to various providers of clinical services, including outpatient hospital, ambulatory surgical centers, Home Health and DME providers.

Ongoing training and education are provided specifically for the audit processes, industry changes and other topics as needed. In addition to coding and reimbursement expertise, this remote position requires a self motivated, organized, detail oriented person with superior critical thinking, problem solving and communication skills.

Qualifications

• Current AHIMA or AAPC credentials (RHIT or RHIA and CCS P, CPC, or CPC H/COC)
• Extensive knowledge of ICD 10 and CPT/HCPCS coding guidelines and appropriate use of modifiers.
• Minimum 5 years outpatient/surgical coding experience.
• Understanding of Medicare/Medicaid and Commercial provider reimbursement methodologies.
  
  

Preferred Qualifications

• At least 5 years of experience.
• AHIMA or AAPC credentials (RHIT or RHIA and CCS P, CPC, or CPC H/COC).
• Experience coding specialty surgical areas including orthopedics, cardiology, spine and back, and/or interventional radiology is highly desired.
• Extensive knowledge of ICD 10, CPT/HCPCS coding and APC reimbursement.
• Understanding of Medicare/Medicaid and Commercial provider reimbursement methodologies.
• Should have experience working with an encoder, preferably Trucode, and be accustomed to reviewing medical records remotely.
  
  

Your future duties and responsibilities

Required Qualifications To Be Successful In This Role

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Life at CGI is rooted in ownership, teamwork, respect and belonging. Here, you’ll reach your full potential because…

You are invited to be an owner from day 1 as we work together to bring our Dream to life. That’s why we call ourselves CGI Partners rather than employees. We benefit from our collective success and actively shape our company’s strategy and direction.

Your work creates value. You’ll develop innovative solutions and build relationships with teammates and clients while accessing global capabilities to scale your ideas, embrace new opportunities, and benefit from expansive industry and technology expertise.

You’ll shape your career by joining a company built to grow and last. You’ll be supported by leaders who care about your health and well-being and provide you with opportunities to deepen your skills and broaden your horizons.

That same commitment to fairness extends to how we use technology. To support our recruitment team, AI tools may be used to help assess applications though they never replace human judgement. All hiring decisions remain entirely in the hands of our recruitment professionals.

Come join our team—one of the largest IT and business consulting services firms in the world.

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