Surgical PB Auditor: Precision, Compliance & Impact

Sage Clinical RCM, LLC; Saint Petersburg (FL); On-site; USD 60,000 - 80,000; Full time

Job summary

Sage Clinical RCM, LLC is seeking a Professional Billing Auditor focused on surgical specialties in Saint Petersburg, Florida. The role involves auditing professional fee claims for accurate coding and compliance, while providing constructive feedback to billing coders. Candidates must have at least 2 years of relevant experience, strong knowledge of surgical coding, and effective communication skills. Preferred certifications include CPC or CPMA. Join us to enhance audit standards and support improvement efforts.

Qualifications

• Minimum 2+ years of professional billing auditing experience with a focus on surgical services.
• Experience auditing hospital-based physician surgical billing claims is essential.
• Strong ability to provide constructive audit feedback.

Responsibilities

• Perform retrospective and/or concurrent audits of professional billing surgical claims.
• Review operative reports to validate appropriate CPT, HCPCS, and ICD-10-CM code assignment.
• Identify surgical coding trends, compliance risks, and opportunities for improvement.

Skills

Professional billing auditing experience

Knowledge of CPT (Surgery section)

Knowledge of ICD-10-CM

Modifier usage and bundling knowledge

Verbal communication skills

Written communication skills

Education

CPC, CPMA, or equivalent certification

Job description

Sage Clinical RCM, LLC is seeking a Professional Billing Auditor focused on surgical specialties in Saint Petersburg, Florida. The role involves auditing professional fee claims for accurate coding and compliance, while providing constructive feedback to billing coders. Candidates must have at least 2 years of relevant experience, strong knowledge of surgical coding, and effective communication skills. Preferred certifications include CPC or CPMA. Join us to enhance audit standards and support improvement efforts.