Professional Coding Auditor/Consultant

Greater North Fulton Chamber of Commerce; Charlotte, Tampa, Nashville, Atlanta, Knoxville (NC, FL, TN, GA, TN); On-site; USD 60,000 - 100,000; Full time

Job summary

Join a leading professional services firm as a Professional Coding Auditor/Consultant, where you will play a crucial role in ensuring quality assurance in coding audits. This dynamic position involves working closely with healthcare providers to improve documentation and compliance while navigating complex coding guidelines. You will be part of a collaborative team that values innovation and excellence, offering competitive compensation and opportunities for professional growth. If you are detail-oriented and possess strong communication skills, this is the perfect opportunity to advance your career in a supportive environment.

Benefits

Competitive compensation

Comprehensive benefits

Opportunities for career advancement

Qualifications

• CPC/CCS-P or related coding professional credential required.
• Expertise in E/M and surgical coding, especially cardiology and orthopedic surgery.

Responsibilities

• Conduct quality assurance reviews of coding audits and assist clients with documentation improvement.
• Provide advisory support for billing and regulatory compliance.

Skills

Professional coding auditing expertise

Strong communication skills

Project management skills

Detail-oriented

Ability to work in a fast-paced environment

Education

CPC/CCS-P credential

Additional credentials (RHIT, CCS, CPMA)

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 Integrityteam in a quality assurance and project management role.

RESPONSIBILITIES:

• Responsible for the accurate quality assurance review of PYA coding audits, as well as 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. Professional coding auditing expertise in multiple specialties is required, including strength in E/M and surgical coding, especially cardiology and orthopedic surgery. Expertise in facility inpatient and outpatient coding auditing is preferred but not required.
• The Consultant will assist PYA clients with provider documentation improvement, reviews for billing and other regulatory compliance with third party payers, revenue cycle management, as well as reimbursement methodology advisory support.

REQUIREMENTS:

• 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 required
• Experience in surgical coding auditing is required (cardiology and orthopedic surgery is preferred)
• Additional credentials such as RHIT, CCS, CPMA, or specialty designations desirable
• Physician financial reimbursement and revenue cycle understanding is preferred
• Knowledge related to post-acute coding and billing (SNF, Home Health, Palliative Care, Behavioral Health) is a plus
• Experience presenting to physicians and other healthcare providers required
• Ability to work in a fast-paced, high-volume coding audit (5-7 encounters per hour average expected) environment with a team, which expects high-quality deliverables and accuracy to clients
• Superior communication skills, both oral and written
• Excellent project management skills
• Traits that include detail-oriented, 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 aboutThe PYA Way .

Why Join PYA?

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