Medical Coding Auditor - Surgical Services

Integrative Emergency Services, LLC; United States; Hybrid; USD 70,000 - 95,000; Full time

Job summary

Integrative Emergency Services, LLC is seeking a Medical Coding Auditor focused on surgical services to ensure accurate CPT, ICD-10-CM, and HCPCS Level II coding within payer guidelines. The role supports documentation integrity and identifies coding risks through audits and projects.

Remote or hybrid work is possible, with residency in states IES operates in. Candidates should have five years of coding experience, strong surgical coding, and CPC or CCS-P certification.

Qualifications

• Five (5) years of professional medical coding experience.
• Strong surgical coding experience required.
• Active coding certification through AAPC (CPC) or AHIMA (CCS-P).

Responsibilities

• Assign CPT, ICD-10-CM, and HCPCS Level II codes for professional surgical services.
• Evaluate records for medical necessity and accuracy.
• Ensure coding compliance with CMS and payer guidelines.
• Identify undercoding, overcoding, and unbundling issues.
• Review payer policies and stay current on coding updates.
• Collaborate with providers to clarify documentation.
• Maintain productivity and quality benchmarks.

Skills

Surgical coding knowledge

CPT coding

ICD-10-CM coding

HCPCS Level II coding

NCCI edits understanding

Documentation review

Analytical thinking

Attention to detail

Communication skills

Multitasking

Education

CPC or CCS-P certification

High school diploma or equivalent

Tools

EHR systems

Practice management systems

Claim scrubber tools

Job description

DISCOVER IES

Integrative Emergency Services ("IES") LLC, is a physician founded, owned, and led company whose goal is to empower physician leaders to create the best places to give and receive care. We are a clinically integrated and outcomes-based organization with a commitment to doing the right thing for our clinicians, patients, and communities. Through our commitment to patient care and reinvestment in our physicians, IES has a proven track record of improving patient outcomes and producing results that uphold the hospitals' reputations in which we operate. We strive to create a culture of continuous improvement, community, and recognizing our Physician leaders. To learn more, visit our website IES.Healthcare and click to see a highlight of our 12th Annual Quality Summit.

POSITION SUMMARY

Integrative Emergency Services, LLC ("IES") is seeking a Medical Coding Auditor with emphasis on surgical services. Although a surgical related coding certification is preferred, a related certification from AAPC or AHIMA is acceptable.

The Medical Coding Auditor is responsible for accurate professional fee coding and documentation review for assigned surgical service lines (URSA / NTCC / TSN). This role evaluates medical records to ensure proper CPT, HCPCS Level II, and ICD-10-CM code assignment in accordance with payer guidelines and regulatory standards. This role supports documentation integrity, identifies coding compliance risks (including undercoding, overcoding, and unbundling), and contributes to clean claim submission and optimal reimbursement through coding analysis, audits, and special projects.

Candidates can work in either a hybrid or remote setting. If remote, must reside in a state IES operates in: AZ, CO, TX, OK, IN, MO, AL, SC, FL

ESSENTIAL DUTIES AND RESPONSIBILITIES

The responsibilities listed here represent the majority of the role but are not all-inclusive; other duties may be assigned.

• Accurately assign CPT, ICD-10-CM, and HCPCS Level II codes for professional surgical services based on thorough medical record review.
• Evaluate medical records for proper code assignment, completeness, accuracy, and support of medical necessity.
• Ensure coding compliance with CMS, commercial payer, and regulatory guidelines.
• Identify and address undercoding, overcoding, modifier misuse, and unbundling issues.
• Apply appropriate modifiers and ensure correct provider, place of service, and payer selection.
• Conduct claim review to support clean claim submission and reduce denials.
• Audit coding accuracy through ad hoc reports, focused reviews, and special projects.
• Analyze coding-related denials and recommend corrective actions.
• Review payer policies and stay current on annual coding updates and regulatory changes.
• Collaborate with providers and operational leadership to clarify documentation and improve coding specificity.
• Maintain productivity and quality benchmarks established by the department.
• Serve as a subject matter resource for surgical coding guidance within assigned service lines.

QUALIFICATIONS

Knowledge, Skills, Abilities:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

• High-level knowledge of general surgery-related medical terminology, anatomy, and pathophysiology.
• Strong understanding of CPT procedure coding, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis coding.
• Knowledge of coding in surgical practices, ambulatory surgery centers, and hospital settings.
• Ability to evaluate documentation for medical necessity and coding compliance.
• Strong understanding of National Correct Coding Initiative (NCCI) edits and bundling guidelines.
• Ability to audit reports, conduct focused reviews, and participate in special projects.
• Advanced analytical and problem-solving skills.
• High attention to detail and accuracy.
• Proficiency with EHR systems, practice management systems, and claim scrubber tools.
• Strong written and verbal communication skills.
• Ability to manage multiple priorities and meet deadlines.
• Proficiency in Microsoft Office applications.
• Ability to maintain confidentiality and exercise professional discretion.

Education / Experience:

Include minimum education, technical training, and/or experience preferred to perform the job.

Required:

• High school diploma or equivalent.
• Minimum five (5) years of professional medical coding experience.
• Strong surgical coding experience required.
• Active coding certification through: American Academy of Professional Coders (AAPC) (ie. CPC), or American Health Information Management Association (AHIMA) (ie.CCS-P).

Preferred:

• Surgical related Coding Certification (CGSC, CASCC, CCVTC, etc)
• Certified Professional Medical Auditor (CPMA) through AAPC.
• Experience conducting internal coding audits.
• Experience with CMS Part B and commercial payer reimbursement methodologies.

PHYSICAL DEMANDS:

• Specific vision requirements include the ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus
• While performing the duties of this job, the employee is regularly required to talk and hear
• Frequently required to stand, walk, sit, use hands to feel, and reach with hands and arms.
• Possess the ability to fulfill any office activities normally expected in an office setting, to include, but not limited to remaining seated for periods of time to perform computer-based work, participating in filing activity, lifting and carrying office supplies (paper reams, mail, etc.)
• Occasionally lift and/or move up to 20-25 pounds
• Fine hand manipulation (keyboarding)

WORK ENVIRONMENT:

• Hybrid office environment or flexible for remote
  • Corporate office: 4835 Lyndon B Johnson Fwy, Dallas, TX 75244
• If remote, must reside in a state IES operates in
  • Arizona, Colorado, Texas, Oklahoma, Indiana, Missouri, Alabama, South Carolina, & Florida

TRAVEL:

• Some travel, including overnight and local, may be required as business needs dictate.

ADA & Reasonable Accommodation Statement:

IES is committed to providing equal employment opportunities to qualified individuals with disabilities. In accordance with the Americans with Disabilities Act (ADA), reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job. If you require accommodation during the application or employment process, please contact [e-mail].

The company is committed to creating a diverse, inclusive, and equitable environment and is proud to be an equal opportunity employer. Qualified applicants of any age, race, religion, nationality, sexual orientation, gender identity or expression, disability, or veteran status will receive equal consideration for positions. We welcome people of diverse backgrounds, experiences, and abilities and believe that the unique experiences of our team drive our success.