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