Professional Coding Auditor / Consultant

PYA P C; Atlanta (GA); On-site; USD 80,000 - 120,000; Full time

Job summary

PYA P C is seeking a Professional Coding Auditor/Consultant with 5-7 years of experience to enhance its Revenue Integrity team. Responsibilities include auditing complex coding, providing education to healthcare providers, and supporting coding compliance initiatives. The role offers competitive compensation and a collaborative work environment focused on professional growth.

Benefits

Competitive compensation

Comprehensive benefits

Career advancement opportunities

Qualifications

• 5-7 years in multiple specialty coding auditing.
• Expertise in E/M and surgical coding across 5-10 specialties.
• Experience with high-volume coding audits (4-6 encounters/hour).

Responsibilities

• Review of clients’ professional fee coding per audit standards.
• Support management tasks and client communications.
• Conduct provider coding and documentation education remotely.

Skills

Detail-oriented

Communication

Time Management

Project Management

Flexibility

Education

CPC / CCS-P credential

RHIT, CCS, CPMA (desirable)

Tools

Audit Manager

Intellicode

MDAudit

Job description

PYA is seeking a Professional Coding Auditor / Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role.

RESPONSIBILITIES :

• Responsible for the accurate review of PYA clients’ professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education (generally conducted remotely).
• Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD / LCD requirements. Expertise in multiple specialties is required, including strength in E / M and surgical coding, preferably including cardiology and orthopedic surgery. Facility inpatient and outpatient coding auditing experience is preferred but not required.
• The Consultant will assist PYA clients with provider coding and documentation improvement, reviews for billing and regulatory compliance, revenue cycle management, and reimbursement methodology advisory support.

REQUIREMENTS :

• 5-7 years of experience in multiple specialty coding auditing
• Expertise in E / M and surgical coding across 5-10 specialties, with high working knowledge in more
• Experience with auditing thousands of records per year
• Experience using audit tools such as Audit Manager, Intellicode, MDAudit, etc.
• Ability to work in a fast-paced, deadline-driven environment
• Current credential of CPC / CCS-P or related coding professional credential required
• Strong understanding of and experience in auditing for compliance with 1995, 1997, and 2021 / 2023 E / M Guidelines
• Experience in surgical coding auditing (cardiology and orthopedic surgery preferred)
• Additional credentials such as RHIT, CCS, CPMA, or specialty designations are desirable
• Knowledge of physician practice operations, including reimbursement and revenue cycle, is a plus
• Knowledge of post-acute coding and billing (SNF, Home Health, Palliative Care, Behavioral Health) is a plus
• Experience presenting to and educating healthcare providers is preferred
• Ability to handle high-volume coding audits (4-6 encounters per hour) with a team, ensuring high-quality, accurate deliverables
• Superior communication skills, both oral and written
• Excellent project and time management skills
• Traits including being detail-oriented, organized, flexible, and responsive

ABOUT PYA

PYA, a leading professional services firm, serves clients across the United States with expertise in healthcare consulting, accounting, compliance, and business strategy. With offices in Knoxville, Atlanta, Tampa, Charlotte, Nashville, and Kansas City, PYA is committed to helping clients achieve their goals through innovative solutions and unparalleled service. Learn more about The PYA Way.

Why Join PYA?

• Be part of a dynamic and collaborative team that values innovation and excellence
• Work with industry leaders committed to professional growth and client success
• Enjoy competitive compensation, comprehensive benefits, and career advancement opportunities