Remote Healthcare Coding Auditor: Quality & Compliance

Surgery Partners; United States; Remote; USD 85,000 - 110,000; Full time

Job summary

Surgery Partners seeks a Coding Auditor to evaluate and improve coding quality, accuracy, and compliance across internal and outsourced vendors in ASC, professional fee, and hospital outpatient settings. You will report to the Coding Vendor Manager and drive improvement initiatives.

You will audit ICD-10-CM/PCS, CPT, CPT, CMS policies, and payer requirements, providing education and feedback to coders and supporting performance dashboards and action plans across multiple service lines.

Qualifications

• Bachelor's degree preferred or equivalent experience.
• 5+ years coding experience.
• 3+ years coding audit experience.
• 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 organizational standards.
• Validate documentation and medical necessity.
• Monitor coding quality and trends.
• Assist with scorecards and corrective action plans.
• Support internal/external audits and regulatory compliance.
• Provide coder education and feedback.
• Partner with Revenue Integrity, HIM, Compliance, CDI, and Operations.
• Prepare audit reports, dashboards, and trend analyses.
• Recommend process improvements and maintain coding policies.

Skills

ICD-10-CM/PCS

CPT coding

HCPCS coding

NCCI

ASC coding

Professional Fee coding

Analytical skills

Communication skills

Auditing skills

Documentation review

Education

Bachelor's degree

Tools

Encoder systems

EHRs

Auditing software

Excel

Microsoft Office

Job description

Surgery Partners seeks a Coding Auditor to evaluate and improve coding quality, accuracy, and compliance across internal and outsourced vendors in ASC, professional fee, and hospital outpatient settings. You will report to the Coding Vendor Manager and drive improvement initiatives.

You will audit ICD-10-CM/PCS, CPT, CPT, CMS policies, and payer requirements, providing education and feedback to coders and supporting performance dashboards and action plans across multiple service lines.