Senior Auditor, Revenue Optimization (Remote)

North American Partners in Anesthesia; United States; Teletrabalho; USD 63 000 - 87 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Paid Time Off

Health, life, vision, dental,di s&dis

Flexible Spending Accounts/Health Sav

401(k)

Leadership and professional developm

Annual performance reviews

Resumo da oferta

North American Partners in Anesthesia in Sunrise, FL is seeking a Senior Auditor, Revenue Optimization – Pod Captain to lead audit activities and guide auditors in coding, billing and documentation for anesthesia services.

The role provides operational guidance, quality oversight, and coaching, while collaborating with management to identify revenue opportunities and ensure compliance with regulatory requirements.

Qualificações

• Minimum 5 years of professional medical coding, auditing, revenue integrity, or revenue cycle experience.
• Advanced knowledge of anesthesia coding, billing, documentation, and reimbursement requirements.
• Ability to interpret CPT, ICD-10-CM, HCPCS, payer requirements and CMS guidance.

Responsabilidades

• Provide day-to-day functional leadership and SME guidance for audit processes.
• Perform complex revenue optimization audits and identify under- or over-coding opportunities.
• Conduct quality assurance reviews and provide constructive feedback to the team.
• Develop and present audit results with recommendations to management.
• Utilize data analytics to identify patterns and revenue integrity concerns.

Conhecimentos

Leadership

Auditing

Data analysis

Communication

Formação académica

CPC or CCS certification

CPMA or CANPC certification

Ferramentas

Microsoft Excel

Analytics software

Descrição da oferta de emprego

Sunrise,FL - USA

Position Requirements

ACTIVITY / RESPONSIBILITY

Team Leadership & Operational Support: Provide day-to-day functional leadership and technical support to Revenue Optimization Auditors. Serve as a primary Subject Matter Expert (SME) for audit processes, coding and billing questions, departmental policies, and workflow requirements. Provide guidance on complex cases, support workload coordination, reinforce departmental expectations, and elevate significant operational, performance, or compliance concerns to the Manager as appropriate.

Revenue Optimization Auditing: Perform and support complex revenue optimization audits, including coding, billing, documentation, revenue integrity, and other assigned audit activities. Evaluate records for accuracy, completeness, and adherence to applicable requirements while identifying under-coding, over-coding, missed billing opportunities, documentation deficiencies, and other potential revenue or compliance concerns.

Quality Assurance: Conduct scheduled quality assurance reviews of auditor work to evaluate accuracy, consistency, documentation, and adherence to established audit methodology, policies, and procedures. Provide timely and constructive feedback, identify trends requiring additional education or process clarification, and communicate significant findings to management.

Reporting & Recommendations: Develop, review, and present audit results and supporting examples to management and other stakeholders. Summarize key findings, revenue opportunities, coding and documentation trends, compliance considerations, root causes, and recommended corrective or preventive actions.

Data Analysis & Revenue Integrity: Utilize available reporting and data analytics tools to analyze audit populations and large datasets, identify patterns and anomalies, and evaluate potential revenue integrity concerns, including under-coding, over-coding, missed charges, documentation deficiencies, and other billing opportunities or risks.

Education & Staff Development: Provide coaching, education, and technical guidance to Auditors, Coders, Physicians, and other stakeholders, as appropriate, regarding audit findings, coding guidelines, documentation requirements, revenue cycle processes, and identified opportunities for improvement.

New Hire Training & Onboarding: Support the onboarding and development of newly hired Revenue Optimization Auditors by providing workflow training, technical instruction, mentoring, case review, and ongoing feedback to promote successful transition into independent audit responsibilities.

Process Improvement: Promote continuous improvement by identifying opportunities to strengthen audit methodology, standardize workflows, improve quality and efficiency, enhance reporting, and optimize revenue cycle outcomes. Participate in departmental initiatives and special projects as assigned.

Meetings, Escalations & Operational Coordination: Coordinate and participate in team, departmental, and management meetings; communicate relevant operational updates; support resolution of escalated issues; and assist the Manager with departmental priorities, coverage needs, and other operational responsibilities as assigned.

REQUIRED QUALIFICATIONS

• High school diploma or equivalent required.
• Current CPC or CCS certification, plus CPMA, CANPC, or an equivalent professional auditing or anesthesia coding certification.
• Minimum of 5 years of professional medical coding, auditing, revenue integrity, or revenue cycle experience, including significant experience auditing anesthesia services.
• Advanced knowledge of anesthesia coding, billing, documentation, and reimbursement requirements.
• Demonstrated ability to interpret and apply CPT, ASA Crosswalk, ICD-10-CM, HCPCS, payer requirements, CMS guidance, and other applicable coding and billing regulations.
• Demonstrated experience performing coding, documentation, revenue optimization, or compliance-focused audits.
• Strong analytical skills with the ability to evaluate complex information, identify trends and root causes, and translate findings into actionable recommendations.
• Demonstrated ability to provide technical guidance, coaching, training, and constructive feedback to peers and team members.
• Strong written and verbal communication skills, including the ability to communicate complex audit and coding concepts clearly to technical and non-technical audiences.
• Strong organizational and time-management skills with the ability to manage competing priorities, meet deadlines, and support multiple concurrent audit activities.
• Demonstrated sound judgment, professionalism, discretion, and ability to appropriately elevate operational or compliance concerns.
• Proficiency with Microsoft Excel and other Microsoft Office applications; ability to work effectively with audit, reporting, revenue cycle, and data analytics systems.
• Ability to work independently in a remote environment while maintaining effective communication and collaboration with team members, leadership, and cross-functional stakeholders .

DESIRED/PREFERRED QUALIFICATIONS

• Prior experience serving as a team lead, senior auditor, subject matter expert, trainer, or similar functional leadership role
• Experience conducting internal and/or external coding audits, revenue optimization audits, payer audits, or revenue integrity reviews.
• Experience developing audit reports, presenting findings to leadership, and providing education based on audit results.
• Experience analyzing audit data and identifying systemic revenue, coding, documentation, or workflow trends.

Total Rewards:

• Salary: $63,000 - $87,000 annually
• Generous benefits package, including:
  • Paid Time Off
  • Health, life, vision, dental, disability, and AD&D insurance
  • Flexible Spending Accounts/Health Savings Accounts
  • 401(k)
  • Leadership and professional development opportunities

The Senior Auditor, Revenue Optimization – Pod Captain serves as a senior subject matter expert and day-to-day functional leader within the Revenue Optimization Audit team. This role provides operational guidance, technical support, quality oversight, and coaching to Revenue Optimization Auditors while supporting the Manager in ensuring audit activities are completed accurately, consistently, and in accordance with departmental standards and applicable coding, billing, and regulatory requirements.

The Pod Captain serves as a primary escalation resource for complex audit, coding, documentation, and workflow questions and assists with workload coordination, team development, onboarding, quality assurance, and process improvement initiatives. The position also performs and supports complex revenue optimization audits and uses audit findings and data analysis to identify revenue opportunities, compliance risks, documentation trends, and opportunities for operational improvement.

EEO Statement

North American Partners in Anesthesia is an equal opportunity employer.