Professional Fee QA Analyst

GeBBS Healthcare Solutions is seeking an experienced Professional Fee (ProFee) Inpatient & Outpatient Coding Auditor to join our team in a remote, part-time capacity, Monday-Friday

The ideal candidate brings a strong background in professional fee coding and auditing across hospital-based inpatient and outpatient services, with expertise in ICD-10-CM, CPT, HCPCS, and modifier assignment to include Hospital E/M leveling, Bedside procedures, Office E/M leveling and in-office procedures.

In this role, you will conduct coding audits, identify compliance risks, evaluate documentation accuracy, and provide meaningful feedback and education to coding professionals. Your expertise will help ensure coding accuracy, regulatory compliance, reimbursement integrity, and continuous quality improvement.

Key Responsibilities

• Conduct comprehensive audits of professional fee inpatient and outpatient coding to ensure accuracy, completeness, and compliance with coding guidelines and payer requirements.
• Review medical records and validate ICD-10-CM, CPT, HCPCS Level II, and modifier assignments to include Hospital E/M leveling, Bedside procedures, Office E/M leveling and in-office procedures..
• Identify coding errors, documentation gaps, compliance risks, and opportunities for improvement.
• Evaluate appropriate modifier usage, code selection, and sequencing in accordance with applicable guidelines.
• Ensure compliance with CMS regulations, Official Coding Guidelines, Coding Clinic guidance, NCCI edits, OCE edits, and payer-specific policies.
• Prepare clear, detailed audit reports outlining findings, recommendations, and educational opportunities.
• Provide constructive feedback, coaching, and coding education to improve accuracy and consistency.
• Monitor coding quality trends, identify root causes of errors, and recommend corrective actions.
• Collaborate with coding leadership and operational teams to support quality assurance and process improvement initiatives.
• Research coding updates, reimbursement regulations, and payer guidelines to maintain compliance with industry standards.
• Meet established productivity, quality, and turnaround time expectations.

Required Qualifications

• Minimum 3 years of professional fee coding experience within hospital-based inpatient and/or outpatient settings.
• Minimum 2 years of coding auditing, quality assurance, compliance, or coding education experience.
• Active CPC, CPMA, or equivalent AHIMA/AAPC certification required.
• Strong proficiency in ICD-10-CM, CPT, HCPCS Level II, and modifier assignment.
• Demonstrated knowledge of professional fee coding guidelines, Medicare, Medicaid, commercial payer requirements, and reimbursement methodologies.
• Experience applying Official Coding Guidelines, Coding Clinic guidance, NCCI edits, OCE edits, and payer-specific policies.
• Proven ability to identify coding discrepancies, compliance concerns, and opportunities for quality improvement.
• Experience providing audit feedback, coding education, or coaching to coding professionals.
• Proficiency with EHR systems, encoder software, auditing platforms, and revenue cycle applications.
• Strong analytical, research, documentation, and communication skills.
• Ability to work independently, manage competing priorities, and consistently meet deadlines.

Preferred Skills & Experience

• Experience auditing both inpatient and outpatient professional fee services.
• Strong knowledge of hospital-based physician billing and coding practices.
• Experience developing educational materials or supporting coding quality improvement initiatives.
• Familiarity with computer-assisted coding (CAC) tools and coding audit reporting systems.
• Proficiency in Microsoft Excel, Word, and reporting tools.
• Ability to communicate audit findings effectively to coding professionals, management, and client stakeholders.
• Epic experience.

Position Details

Location: 100% Remote – United States

Schedule: Part-Time, 20 Hours per Week, Monday - Friday (no weekends)

Compensation: $27.00 per Hour

Position: ProFee Inpatient & Outpatient Coding Auditor

Why Join GeBBS?

At GeBBS Healthcare Solutions, you'll have the opportunity to apply your coding expertise, support quality improvement, and contribute to the success of healthcare organizations nationwide—all while working remotely.

If you're a detail-oriented coding professional with a passion for accuracy, compliance, and education, we'd love to hear from you!

Apply today and become part of the GeBBS Healthcare Solutions team!