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Surgical Coding Auditor

1 hour, 10 minutes ago
Anywhere
Full-time
Senior
Compliance Manager
Finance and Accounting
HIPAA
Apply Now
Alteva RCM

Alteva RCM

Alteva RCM specializes in healthcare revenue cycle management and operational support, providing innovative solutions to enhance the efficiency and effectiveness of healthcare financial processes.

Health Care Providers & Services
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Description

  • Conduct coding audits across assigned specialties, coders, and client accounts to assess documentation, coded encounters, and guideline compliance.
  • Evaluate code selection, sequencing, modifiers, units, and alignment between clinical documentation and reported codes.
  • Apply ICD-10-CM, CPT, HCPCS, modifier rules, and payer-specific requirements to audit determinations.
  • Complete assigned audit volumes within established turnaround, quality, and methodology standards.
  • Document audit discrepancies, root causes, corrective recommendations, and supporting coding or regulatory references.
  • Prepare audit reports, maintain complete audit records, and compile data for trend analysis and reporting.
  • Communicate constructive findings and individualized coding feedback; support audit-driven education and team sessions.
  • Perform re-audits to assess corrective action effectiveness and identify recurring accuracy or compliance risks.
  • Escalate complex coding scenarios and potential compliance issues to senior audit leadership.
  • Maintain confidentiality of protected health information in accordance with HIPAA and organizational policies.

Requirements

  • Active CPMA certification plus CPC, CCS, RHIT, or RHIA certification.
  • 5+ years of surgical coding experience.
  • At least 1 year of coding audit experience; 2+ years preferred.
  • Knowledge of ICD-10-CM, CPT, HCPCS, modifier rules, payer requirements, and coding compliance guidelines.
  • Proficiency with Microsoft Excel, Word, and Outlook.
  • Experience with reporting and data analysis tools (preferred).
  • Ability to manage competing priorities and meet deadlines in a fast-paced environment.
  • Strong communication, interpersonal, organizational, and attention-to-detail skills.
  • Ability to work independently while contributing to a team-oriented environment.
  • Proactive problem-solving approach and ability to handle complex scenarios appropriately.

Benefits

  • Salary range of $80,000–$100,000 USD.
  • Health, dental, and vision insurance.
  • Employee assistance plan and paid family leave.
  • Short-term disability and life insurance.
  • 401(k) plan with employer match.
  • Flexible spending accounts.
  • Employee discount and referral programs.

Interested in this position?

Apply directly on the company website

Apply Now

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