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Professional Coder and Auditor
<p style="line-height:normal;"><strong><span style="font-size:12pt;">Position Summary</span></strong></p> <p style="line-height:normal;"><span style="font-size:12pt;">J2 Integrity Solutions is seeking a Professional Coder/Auditor to support client engagements through a blended role that pivots between coding production and coding audit responsibilities. This position is ideal for a high-performing professional coder who is equally confident performing accurate and timely coding while also evaluating documentation and coding quality through structured audit reviews.</span></p> <p style="line-height:normal;"><span style="font-size:12pt;">The Professional Coder & Auditor will serve as a subject matter expert in ICD-10-CM, CPT, HCPCS, modifiers, and applicable CMS and payer-specific requirements. This role plays a key part in ensuring accurate billing, supporting revenue integrity, reducing compliance risk, and identifying education opportunities that strengthen documentation and coding performance.</span></p> <p style="line-height:normal;"><span style="font-size:12pt;">In addition to day-to-day coding and auditing work, this position will contribute to the development of educational tools and training materials to promote coding best practices and continuous improvement. The ideal candidate is detail-oriented, efficient, highly analytical, and able to pivot seamlessly between productivity-driven coding responsibilities and quality-focused audit work.</span></p> <p style="line-height:normal;"><strong><span style="font-size:12pt;">Key Responsibilities</span></strong></p> <ul> <li style="line-height:normal;"><span style="font-size:12pt;">Pivot between production coding and audit responsibilities based on client needs and internal priorities.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Perform accurate, timely professional fee coding across assigned specialties and services, meeting defined productivity and quality benchmarks.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Assign appropriate ICD-10-CM, E/M, CPT, HCPCS, and modifiers in accordance with official guidelines and client-specific policies.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Ensure coding aligns with CMS, AMA, payer-specific policies, and NCCI edits to support clean claims and denials prevention.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Meet defined productivity and turnaround time expectations while maintaining high quality standards.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Conduct structured audits of coded encounters to validate coding accuracy, documentation integrity, and compliance.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Audit and validate E/M leveling using current CMS/AMA guidelines, including time and complexity-based models.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Identify under coding, over coding, missed charges, risk-adjustment and HCC opportunities, compliance risk, and revenue opportunities.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Document audit findings with clear rationale, applicable guideline references, and recommended actions.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Provide respectful, constructive feedback to coders, providers, and stakeholders, including navigating difficult conversations when needed.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Identify trends, root causes, and recurring patterns impacting coding quality and documentation, and translate them into practical education and process recommendations.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Develop tip sheets, SOPs, job aids, and training tools to promote coding consistency and best practices.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Deliver targeted data-driven education and coaching based on audit findings and performance gaps.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Collaborate with Coding, CDI, Revenue Integrity, and Compliance teams to support denial prevention, revenue protection, and accurate quality reporting.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Serve as a professional representative and brand ambassador of J2 Integrity Solutions, modeling integrity, and client-focused problem solving.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Roll up your sleeves to assist with the day-to-day support needed. Create internal policies, procedures, and work efforts at J2.</span></li> </ul> <br> <p style="line-height:normal;"><strong><span style="font-size:12pt;">Other duties as assigned.</span></strong><span style="font-size:12pt;"> As a growing company, team members regularly contribute beyond client work. In addition to your primary focus on professional coding and audit work, you may also contribute to internal initiatives such as developing J2-branded content and tools, supporting operational workflows, assisting with marketing and thought leadership, participate in industry events, and cultivate your professional presence on platforms like LinkedIn in alignment with the J2 brand.</span></p> <br> <p style="line-height:normal;"><span style="font-size:12pt;">We believe in working at the top of our license, stretching ourselves, and stepping into the uncomfortable – together. Flexibility, initiative, and team-oriented mindset are essential. At J2, you won't be left on an island; we'll support one another as we grow and build something meaningful.</span></p> <br> <p style="line-height:normal;"><strong><span style="font-size:12pt;">Qualifications & Experience</span></strong></p> <ul> <li style="line-height:normal;"><strong><span style="font-size:12pt;">Certification:</span></strong><span style="font-size:12pt;"> CCS, CCS-P, CPC, RHIT, RHIA, CPMA, or equivalent required.</span></li> <li style="line-height:normal;"><strong><span style="font-size:12pt;">Experience:</span></strong> <ul> <li style="line-height:normal;"><span style="font-size:12pt;">3+ years of multi-specialty professional fee coding experience, including E&M.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">2+ years of professional coding audit experience strongly preferred.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Prior experience in a consulting or multi-client environment is a plus.</span></li> </ul> </li> <li style="line-height:normal;"><strong><span style="font-size:12pt;">Technical Proficiency:</span></strong><span style="font-size:12pt;"> Experience with EHR and encoders. Epic preferred.</span></li> <li style="line-height:normal;"><strong><span style="font-size:12pt;">Industry Knowledge:</span></strong><span style="font-size:12pt;"> Deep understanding of ICD-10-CM, CPT, HCPCS, HCC, modifier application, CMS and AMA documentation standards, NCCI edits and payer-specific requirements, and risk adjustment methodologies.</span></li> <li style="line-height:normal;"><strong><span style="font-size:12pt;">Skills:</span></strong> <ul> <li style="line-height:normal;"><span style="font-size:12pt;">Strong written and verbal communication skills, including the ability to deliver feedback clearly and confidently.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Ability to work independently in a remote environment, manage competing priorities, and pivot between coding production and audit responsibilities based on client needs.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">High degree of accountability, integrity, and follow-through in meeting deadlines and delivering quality work.</span></li> <li style="line-height:normal;"><span style="font-size:12pt;">Ability to use data (dashboards, spreadsheets, and metrics) to track trends and outcomes of audits and education.</span></li> </ul> </li> </ul> <p style="line-height:normal;"><strong><span style="font-size:12pt;">Why Join J2 Integrity Solutions?</span></strong></p> <p style="line-height:normal;"><span style="font-size:12pt;">At J2 Integrity Solutions, we are committed to excellence, integrity, and innovation in healthcare coding and compliance. As part of our team, you will have the opportunity to drive meaningful changes, support diverse clients, and be part of a dynamic team of professionals.</span></p>