Surgery Coding Auditor
New
J
JobgetherHealthcare coding
Fully remote within the United States.Full-TimeJunior
Salary38 USD per hour
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Job Details
- Languages
- English-language proficiency required
- Experience
- At least two years of coding experience in the applicable coding specialty; at least three years of consultant experience reviewing records in large tertiary-care hospitals and outpatient organizations; at least three years of education and training experience.
- Required Skills
- EHR
Requirements
- Hold an active RHIA, RHIT, CCS, CCS-P, CPC, or CPC-H credential from an accepted professional organization.
- Have at least two years of coding experience in the applicable coding specialty.
- Have at least three years of consultant experience reviewing records in large tertiary-care hospitals and outpatient organizations with primary care and subspecialty services.
- Have at least three years of education and training experience, including presenting audit findings and delivering facility-specific coding education.
- Demonstrate strong knowledge of surgical and procedural coding, including ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, modifiers, global surgical packages, bundling rules, reimbursement, documentation, and compliance.
- Assess documentation sufficiency and determine whether surgical and procedural codes are appropriately supported.
- Identify coding discrepancies and explain their compliance, financial, and operational implications.
- Maintain at least 95% audit accuracy while meeting reporting and turnaround requirements.
- Demonstrate written, verbal, presentation, and interpersonal communication skills, with strong attention to detail, organization, documentation, and quality control.
- Work independently and collaborate with health information management leadership and facility stakeholders.
- Successfully complete a Low Risk NACI background investigation and required privacy, information-security, and mandatory training.
- Meet established schedules and requirements for audits, reporting, training, credentialing, and access activities.
Responsibilities
- Audit surgical and procedural coding for accuracy, documentation support, compliance, and reimbursement impact.
- Evaluate ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, modifier, global-package, and Correct Coding Initiative bundling assignments.
- Review surgical diagnoses and procedures in electronic health records and approved audit tools.
- Identify incorrect, missing, unbundled, upcoded, downcoded, unsupported, or otherwise noncompliant codes and modifiers.
- Document audit findings with authoritative coding guidance, financial impact, risk assessment, and recommended corrective action.
- Contribute to audit work plans, collection tools, facility-level and consolidated reports, and progress updates.
- Review preliminary findings with health information management leadership, the Contracting Officer's Representative, management, and facility personnel.
- Prepare or support final reports and deliver facility-specific coding education when assigned.
- Support exit conferences by explaining coding findings, recommendations, and authoritative guidance.
- Protect sensitive healthcare information and comply with privacy, information-security, encryption, and remote-work requirements.
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