Compliance Auditor

Gill Compliance Solutions, LLC; United States; On-site; USD 52,000 - 88,000; Part time

Benefits offered by this job

Remote work

Paid CEUs

Flexible schedule

Job summary

Gill Compliance Solutions is seeking an experienced Cardiology Coding Auditor to join our national consulting team in a part-time, remote role. You will perform audits of CPT, HCPCS, ICD-10-CM codes and modifiers, review documentation, and identify opportunities to improve accuracy and reimbursement.

You will educate physicians and staff, respond to client questions, and stay current with coding guidelines.

Qualifications

• CPC/CCS/CCS-P certification required; cardiology-specific certification strongly preferred.
• Four or more years of physician coding/auditing experience with cardiology.
• Strong ICD-10-CM coding skills, including cardiovascular diagnosis coding.
• Strong E/M coding knowledge, modifiers, NCCI edits, and global surgery rules.
• Experience with cardiac catheterization, interventional cardiology, electrophysiology, and imaging services.
• CMS/Medicare regulatory knowledge; Noridian experience valued.
• Experience educating physicians, staff, and coders; strong communication skills.

Responsibilities

• Perform cardiology coding and documentation audits for CPT, HCPCS, ICD-10 codes and modifiers per guidelines.
• Audit services including E/M, diagnostic cardiology, catheterization, interventional cardiology, electrophysiology, devices, echocardiography, and stress testing.
• Review documentation for accuracy, medical necessity, diagnosis specificity, modifiers, and missed opportunities.
• Identify trends and create practical education for physicians, APPs, coders, and staff.
• Research coding questions, denials, Medicare requirements, NCCI edits, and payor policies.
• Navigate Epic, Cerner, Allscripts to conduct audits; manage work in Smartsheet and Box.

Job description

Cardiology Coding Auditor - Part-Time Remote

Are you passionate about cardiology coding, compliance, and education?

Gill Compliance Solutions (GCS) is growing, and we're looking for an experiencedCardiology Coding Auditorto join our nationally recognized consulting team in apart-time, remote position.

Our consultants work directly with physician practices, hospitals, health systems, emerging healthcare technology companies, and legal firms across the country to improve documentation, coding accuracy, compliance, and reimbursement. Every day presents new challenges and opportunities to make a measurable impact.

If you enjoy auditing complex cardiology services, identifying coding and reimbursement opportunities, educating providers, and solving challenging coding issues, we'd love to meet you.

Duties May Include:

• Perform cardiology coding and documentation audits to ensure accuracy of CPT, HCPCS, ICD-10 codes, and modifiers in accordance with federal, state, Medicare, and payor guidelines.
• Audit cardiology services including E/M, diagnostic cardiology, cardiac catheterization, interventional cardiology, electrophysiology, device procedures, echocardiography, stress testing, and other cardiovascular services. Some of this might include some surgical cardiothoracic cases.
• Review medical record documentation for coding accuracy, medical necessity, diagnosis specificity, appropriate modifiers, and missed coding or reimbursement opportunities.
• Identify documentation and coding trends and prepare practical education for physicians, APPs, coders, and other clinical staff.
• Research and client questions involving coding, denials, rejected claims, Medicare requirements, NCCI edits, and payor policies.
• Navigate Epic, Cerner, Allscripts, and other commonly used EHR systems to conduct audits.
• Effectively manage assigned work and audit projects using systems such as Smartsheet and Box.
• Remain current with CPT, HCPCS, ICD-10-CM, CMS, Medicare, and commercial payor coding and reimbursement requirements.

Job Requirements

We're looking for someone who has:

• CPC, CCS, CCS-P, or equivalent coding certification required.Cardiology-specific certification is strongly preferred.
• Four or more years of physician coding/auditing experience, with cardiology experience. Strong knowledge of cardiology coding, including diagnostic and interventional cardiovascular services.
• Strong ICD-10-CM coding skills, including cardiovascular diagnosis coding, specificity, sequencing, and medical necessity.
• Strong knowledge of E/M coding, modifiers, NCCI edits, global surgery rules, and professional versus technical component billing.
• Experience with cardiac catheterization, coronary interventions, electrophysiology, pacemakers/ICDs, echocardiography, stress testing, and other cardiovascular procedures.
• Strong CMS and Medicare regulatory knowledge.Noridian experience is highly valued.
• Experience educating physicians, clinical staff, and coders.
• Excellent analytical, presentation, communication, and professional writing skills.
• Ability to independently research complex coding and reimbursement questions.
• A passion for helping healthcare organizations improve compliance, documentation, coding accuracy, and reimbursement.

Position

• Part-time, remote
• Flexible schedule
• Paid CEUs
• Compensation DOE
• Opportunity for additional projects based on client needs

Excellent professional references are required.