Profee ED Auditor/QA Specialist

GeBBS Healthcare Solutions is a leading provider of Revenue Cycle Management (RCM) and Risk Adjustment services, helping healthcare organizations optimize operations, improve financial performance, maintain compliance, and enhance the patient experience. Recognized as a KLAS® Top Performer, GeBBS combines innovative technology, industry expertise, and a commitment to excellence to deliver measurable results for clients across the healthcare industry. We are dedicated to being a trusted healthcare partner by upholding the highest standards of quality, information security, and compliance. At GeBBS, we foster a collaborative and growth-oriented culture where employees are empowered to develop their skills, advance their careers, and make a meaningful impact in transforming healthcare. Remote (United States) | Full-Time | Monday–Friday | Flexible Schedule Position Overview GeBBS Healthcare Solutions is seeking an experienced Professional Fee (ProFee) Emergency Department Coding Auditor / QA Specialist to join our remote team. This position is responsible for conducting comprehensive audits of professional Emergency Department coding, with a strong emphasis on ED Evaluation & Management (E/M) leveling, procedure coding, documentation accuracy, and regulatory compliance. The ideal candidate will have a proven background in ProFee ED auditing, exceptional attention to detail, and the ability to identify coding discrepancies, provide actionable feedback, and support ongoing quality improvement initiatives. Key Responsibilities - Perform detailed audits of Professional Fee Emergency Department encounters, ensuring accurate E/M leveling, procedure coding, and appropriate code assignment. - Conduct onboarding coding reviews and quality assessments to support client-specific requirements and standards. - Review medical documentation for compliance with ICD-10-CM, CPT, HCPCS, and applicable payer guidelines. - Identify coding discrepancies, documentation deficiencies, missed charges, and opportunities for improved accuracy and compliance. - Apply current and historical E/M documentation guidelines, including 1995, 1997, and updated 2021 and subsequent guidelines, as applicable to the services being audited. - Prepare accurate audit reports, summarize findings, and provide recommendations for corrective action. - Collaborate with coding teams, leadership, and clients to communicate audit findings and support quality improvement initiatives. - Assist with coder and provider education, including clarification of coding guidelines, documentation requirements, and audit findings. - Maintain established quality and productivity standards while meeting client deadlines. - Stay current with regulatory updates, coding changes, and Medicare, Medicaid, and commercial payer requirements. Required Qualifications - Minimum of 3 years of professional coding auditing experience, specifically involving ProFee Emergency Department services. - Active CEMC and/or CPC certification required. - Demonstrated expertise in Professional Fee ED E/M leveling and procedure coding — both are required. - Strong understanding of Emergency Department documentation, medical necessity, modifier usage, and appropriate code assignment. - Comprehensive knowledge of ICD-10-CM, CPT, HCPCS, and applicable coding and billing regulations. - Knowledge of E/M documentation guidelines and current coding requirements. - Experience conducting detailed coding audits, identifying discrepancies, and providing constructive feedback. - Ability to independently complete manual or technology-assisted coding audits. - Excellent analytical, organizational, written, and verbal communication skills. - Proficiency with Microsoft Office applications, including Excel and Word. - Ability to manage multiple priorities, maintain accuracy, and consistently meet productivity expectations. - Must reside in the United States and be available to work Monday through Friday. Preferred Qualifications - CPMA certification. - Additional AHIMA credentials such as CCS-P, RHIA, or RHIT. - Experience with Revenue Integrity and Charge Capture. - Experience providing coder or physician education and communicating audit findings to stakeholders. - Familiarity with client-specific onboarding reviews, quality assurance processes, and performance reporting. Schedule & Performance Expectations - Employment Type: Full-Time, 40 hours per week. - Work Location: 100% Remote (United States). - Schedule: Monday through Friday, 8 hours per day. - Flexible Working Hours: Following completion of client onboarding, employees may work their daily 8-hour schedule between 5:00 AM and 9:00 PM, based on applicable scheduling requirements. A consistent daily start time is not required. - Productivity Requirement: Minimum 10 encounters per hour (EPH). Why Join GeBBS? At GeBBS Healthcare Solutions, you'll have the opportunity to apply your specialized auditing expertise while contributing to coding accuracy, compliance, and continuous quality improvement. We offer a collaborative remote environment where your knowledge and attention to detail make a meaningful difference. If you are an experienced ProFee Emergency Department Auditor with strong E/M leveling and procedure coding expertise, we encourage you to apply! Originally posted on Himalayas