About this role
Aqusag, LLC
Job Summary
We are engaging Medical Auditors to contribute specialized expertise to a project within the academic medical center landscape. In this role, you'll apply your expertise to help train next-generation AI systems. Your work will shape how models learn, reason, and perform through high-quality, real-world input. No prior experience in AI is required, your domain knowledge is what matters. This opportunity is ideal for experienced professionals with a proven track record in outpatient professional fee coding and audit program oversight, especially within academic medical centers.
Scope of Work:
- Review and audit outpatient professional fee coding for accuracy and compliance.
- Review other coders' work and identify errors, gaps, or inconsistencies.
- Make clear and consistent decisions on complex coding cases.
- Apply expertise in E/M leveling, modifier -25, time vs. MDM, and NCCI bundling.
- Document findings and provide clear written feedback.
- Identify coding trends and recommend improvements.
- Help clarify difficult or ambiguous coding cases.
- Provide timely feedback and complete approximately 10 reviews per day.
- Support quality assurance and audit activities as needed.
Preferred Qualifications:
- AAPC CPC certification; CPMA preferred
- 10+ years of medical experience or experience managing outpatient professional fee coding audits in an Academic Medical Center.
- Experience reviewing and auditing other coders' work.
- Strong knowledge of outpatient professional fee coding and auditing.
- Strong understanding of E/M leveling, modifier -25, time vs. MDM, and NCCI bundling.
- Able to make clear, well-supported decisions and apply guidelines consistently.
- Strong written communication and attention to detail.
- Comfortable providing feedback and helping calibrate other reviewers.
- Experience with QA programs, gold-standard reviews, or AI/ML data validation is a plus.