WFH Licensed Clinical Auditor - Documentation & Coding Discrepancies

Job Overview:

Are you an experienced clinician with an eye for precision in documentation and medical coding?

Our client is seeking a Licensed Clinical Auditor - Documentation & Coding Discrepancies to perform detailed, checklist-based reviews of encounter notes and ensure audit readiness prior to billing. To excel in this role, you must hold an active, verifiable clinical license (RN, LPN/LVN, PT) along with hands-on expertise in wound care documentation and clinical terminology. Key candidates will bring a background in medical billing, records, or healthcare administration, alongside proficiency in ICD-10-CM/CPT systems to resolve pre-billing gaps and eliminate claim denials.

Schedule:

Monday - Friday, flexible within Central Time Zone business hours (20 work hours per week)

Responsibilities:

• Review every assigned encounter checklist-style before claim submission to verify completeness.
• Inspect wound care documentation for required details, accurate measurements, and clinical procedure context.
• Identify potential coding discrepancies (ICD-10-CM, CPT/HCPCS) and missing documentation elements.
• Flag medical necessity issues or complex clinical concerns for qualified/authorized review.
• Place incomplete or non-compliant encounters on hold and actively track their resolution.
• Maintain seamless communication with internal teams while adhering strictly to HIPAA guidelines.
• Support smooth administrative handoffs; final coding approvals and clinical decisions will remain with designated, authorized personnel.

Requirements:

• Active, verifiable clinical license relevant to the role (e.g., RN, LPN/LVN, PT).
• Proven ability to follow structured, checklist-driven review processes with high attention to detail.
• Strong critical thinking skills to spot clinical documentation gaps and potential discrepancies.
• Excellent written and verbal communication skills for tracking and resolving on-hold encounters.
• Ability to work independently and manage daily review volume in a fully remote environment.

Qualifications:

• Background in medical billing, medical records, or healthcare administration.
• Hands-on experience with wound care documentation and clinical terminology.
• Familiarity with ICD-10-CM, CPT/HCPCS coding systems, and standard EHR platforms.
• Prior experience identifying pre-billing documentation gaps to reduce claim denials.

Independent Contractor Perks:

• Permanent work from home
• Immediate hiring

Note:

Please click the "Apply" button to complete your application, including the assessment questions, technical check, and voice recording. Your hourly pay rate will be established based on your performance in the application process; submissions with all requirements fulfilled will receive priority review.

One application, multiple possibilities: When you apply, our team reviews your background against all current openings, not just this one! If a different role fits your skills, we'll get in touch! We also encourage you to keep exploring our job board and apply directly to any position that excites you.