Remote Coding Auditor: Quality & Compliance Expert

DaMar Staffing; United States; Remote; USD 75,000 - 105,000; Full time

Job summary

Surgery Partners is seeking a Coding Auditor to evaluate the quality, accuracy, compliance, and consistency of coding across internal and outsourced vendors in ASC, Hospital Outpatient, and Professional Fee lines. This role reports to the Coding Vendor Manager and performs comprehensive audits and trend analyses.

You will review ICD-10-CM/PCS, CPT, HCPCS, CMS and payer policies, validate documentation, and provide coder education.

Qualifications

• Bachelor's degree or equivalent experience preferred.
• Minimum 5 years coding experience with 3+ years in coding audits.
• Experience auditing ASC, Hospital Outpatient, and Professional Fee coding.
• Vendor auditing experience preferred.

Responsibilities

• Perform routine and targeted audits of internal and outsourced coding vendors.
• Conduct pre-bill, post-bill, focused, and retrospective audits.
• Evaluate coding accuracy, modifier usage, sequencing, documentation support, and compliance.
• Review ICD-10-CM/PCS, CPT, HCPCS, CMS, NCCI, payer policies, and standards.
• Validate documentation and medical necessity.
• Prepare audit reports, dashboards, and trend analyses.

Skills

Coding audits

Auditing

Analytical

Communication

Documentation review

Encoder systems

EHR systems

Auditing software

Excel

Microsoft Office

Education

Bachelor's degree or equivalent experience

Tools

Encoder systems

EHRs

Auditing software

Excel

Microsoft Office

Job description

Surgery Partners is seeking a Coding Auditor to evaluate the quality, accuracy, compliance, and consistency of coding across internal and outsourced vendors in ASC, Hospital Outpatient, and Professional Fee lines. This role reports to the Coding Vendor Manager and performs comprehensive audits and trend analyses.

You will review ICD-10-CM/PCS, CPT, HCPCS, CMS and payer policies, validate documentation, and provide coder education.