Medical Audit Specialist

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Apex Skin is a physician‑led and rapidly growing dermatology practice committed to delivering exceptional patient experiences. We are seeking a skilled and motivated Medical Audit Specialist. The Medical Audit Specialist is responsible for reviewing medical records, billing data, and coding documentation to ensure accuracy, compliance with federal and state regulations, and adherence to organizational policies. This role involves conducting random and focused coding audits, documenting findings, preparing and presenting results, and performing investigations to provide comprehensive feedback.

As a subject matter expert in coding, the Medical Audit Specialist offers guidance and support to maintain compliance with coding standards, regulatory requirements, and best practices. The position is critical for preserving the integrity of healthcare billing and coding, preventing errors, and supporting proper reimbursement processes.

• Full‑time, Monday through Friday (40 hours per week)
• This position is primarily remote; however, candidates must be flexible to attend in‑office meetings and travel to Apex Skin locations as needed to support business objectives.

• Conduct regular and focused audits of medical coding and billing records to assess accuracy and completeness.
• Review clinical documentation (e.g., notes, diagnostic reports, treatment plans, medication orders) for accuracy and compliance.
• Identify and correct coding errors, discrepancies, and potential compliance issues.
• Ensure coding practices comply with HIPAA, CMS, OIG, and payer‑specific guidelines.
• Prepare detailed audit reports and present findings with recommendations for improvement.
• Provide feedback, education, and training to healthcare providers and coding staff on proper coding techniques and areas for improvement.
• Collaborate with providers, coding specialists, and compliance teams to resolve documentation or coding issues.
• Respond to coding questions and provide official coding references and guidelines.
• Oversee the quarterly PA Supervision chart review process.
• Act as the primary contact for RAC audits and related requirements.
• Assist in developing and updating coding policies, procedures, and programs to improve accuracy and compliance.
• Analyze coded data, case mix reports, and statistical reports to identify risks and recommend documentation improvements.
• Support risk assessments, compliance and quality initiatives, and facilitate scheduled external audits.
• Maintain current knowledge of coding principles, standards, healthcare regulations, and payer requirements.
• Monitor industry trends and regulatory changes for potential organizational impact.
• Report compliance and risk issues to the compliance department and recommend process improvements.
• Manage other internal compliance audit tasks assigned.

• Associate’s degree required in Health Information Management or Healthcare Administration;
  Bachelor’s preferred. Equivalent experience may be considered.
• Minimum 5 years of medical coding experience required; 2 or more years auditing experience preferred.
• CPC (Certified Professional Coder) or CCS (Certified Coding Specialist) required.
• CPMA (Certified Professional Medical Auditor) or CHIAP (Certified Healthcare Internal Audit Professional) preferred and highly desirable.
• Strong knowledge of ICD‑10, CPT, HCPCS coding systems.
• Proficiency with EHR systems and audit tools.
• Excellent analytical, communication, and problem‑solving skills.
• Ability to manage multiple priorities and meet deadlines.
• High level of integrity and confidentiality.

• Cross‑training in related departments.
• Potential transition into Compliance or Revenue Cycle Management leadership, or coding/compliance education/training role.
• Apex Skin provides training, mentoring, and development opportunities for individuals who demonstrate skill, reliability, compassion, and clinical accuracy.

• Work performed in a remote home office environment with reliable internet connectivity.
• Prolonged periods of sitting and computer use…