Profee Coding Auditor

1 month ago

Oak Park, United States LaSalle Network Full time

LaSalle Network has partnered with a healthcare company in Oak Park, IL in their search for a Profee Coding Auditor. The Profee Coding Auditor will perform regular audits of professional fee (profee) coding and provider documentation. This role includes verifying the accuracy and completeness of ICD-9-CM, ICD-10-CM, CPT-4 and HCPCS coding, assessing compliance with Medicare, Medicaid and other third-party requirements, and providing specialized training to clinicians on proper documentation and coding practices.

Profee Coding Auditor Responsibilities:

  • Perform regularly scheduled audits of profee coding and provider documentation
  • Verify the accuracy and completeness of ICD-9-CM, ICD-10-CM, CPT-4 and HCPCS coding, including modifiers, units and other variables
  • Ensure providers accurately capture services rendered to patients and assess compliance with Medicare, Medicaid and other third-party payer requirements
  • Re-code encounters from source documentation when errors are identified, complete supporting worksheets documenting the rationale for coding decisions
  • Compare audit findings against provider-generated codes, identifying and recording discrepancies and the logic for changes in coding decisions
  • Provide specialty-specific training to clinicians on documentation of services and appropriate coding of E/M, diagnosis (ICD-9 and ICD-10) and procedures (CPT and HCPCS)
  • Prepare detailed audit reports and present findings to providers and management
  • Collaborate with coding and billing teams to address and resolve coding issues

Profee Coding Auditor Requirements:

  • Certified Professional Coder (CPC), Certified Coding Specialist (CCS) or equivalent certification through AHIMA and/or AAPC is required
  • Expertise in E&M coding is essential
  • 3+ years of professional coding experience, with at least 2 years in an auditing role preferred
  • Strong knowledge of ICD-9-CM, ICD-10-CM, CPT-4 and HCPCS coding systems
  • Experience with Medicare, Medicaid and third-party payer coding and billing requirements
  • Excellent presentation and training skills
  • Strong attention to detail and organizational skills
  • Strong analytical and problem-solving abilities
  • Effective communication and interpersonal skills
  • Ability to work independently and as part of a team
  • Proficiency in using healthcare coding software and electronic health records (EHR) systems


If you are interested in this position and meet the qualifications, please apply today

Thank you,

Wiktoria Worach
Project Manager - Healthcare Revenue Cycle
LaSalle Network

LaSalle Network is an Equal Opportunity Employer m/f/d/v.

LaSalle Network is the leading provider of direct hire and temporary staffing services. For over two decades, LaSalle has helped organizations hire faster and connect top talent with opportunities, from entry-level positions to the C-suite. With units specializing in Accounting and Finance, Administrative, Marketing, Technology, Supply chain, Healthcare Revenue Cycle, Call Center, Human Resources and Executive Search. LaSalle offers staffing and recruiting solutions to companies of all sizes and across all industries.

LaSalle Network is the premier staffing and recruiting firm, earning over 100 culture, revenue and industry-based awards from major publications and having its company experts regularly contribute insights on retention strategies, hiring trends and hiring challenges, and more to national news outlets. LaSalle Network offers temporary Field Employees benefit plans including medical, dental and vision coverage. Family Medical Leave, Worker's compensation, Paid Leave and Sick Leave are also provided. View a full list of our benefits here:

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