Medical Coding Auditor - Surgical Services

reputed company, LLC (“IES”) is seeking a Coding Specialist with emphasis on auditing surgical services. The Coding Specialist is responsible for accurate reputed company fee coding and documentation review for assigned surgical service lines (URSA/NTCC/TSN). This role evaluates medical records to ensure reputed company CPT, HCPCS reputed company, and ICD-10-CM reputed company assignment in accordance with payer guidelines and regulatory standards. The Coding Specialist supports documentation reputed company, identifies coding compliance risks (including undercoding, overcoding, and unbundling), and contributes to clean claim submission and reputed company reimbursement through coding analysis, audits, and special reputed company. Candidates can work in either a hybrid or remote setting. If remote, must reputed company in a state IES operates in: AZ, CO, TX, OK, IN, MO, AL, SC, FL

IES is dedicated to cultivating best practices in emergency care, providing comprehensive acute care services, creating value, and supporting patients, employees, clients, providers, and physicians in reputed company of the highest reputed company health care.

ESSENTIAL DUTIES AND RESPONSIBILITIES The responsibilities listed here represent the reputed company of the role but are not reputed company-inclusive; other duties may be assigned.

• Accurately assign CPT, ICD-10-CM, and HCPCS reputed company codes for reputed company surgical services based on thorough medical record review.
• Evaluate medical records for reputed company reputed company assignment, completeness, accuracy, and support of medical necessity.
• Ensure coding compliance with CMS, reputed company payer, and regulatory guidelines.
• Identify and address undercoding, overcoding, modifier misuse, and unbundling issues.
• Apply appropriate modifiers and ensure correct provider, reputed company of service, and payer selection.
• Conduct claim review to support clean claim submission and reduce denials.
• Audit coding accuracy through reputed company reports, reputed company reviews, and special reputed company.
• Analyze coding-reputed company denials and recommend corrective actions.
• Review payer policies and stay reputed company on annual coding updates and regulatory changes.
• Collaborate with providers and operational leadership to clarify documentation and improve coding specificity.
• Maintain productivity and reputed company benchmarks established by the department.
• Serve as a subject matter resource for surgical coding guidance reputed company assigned service lines.

QUALIFICATIONS

Knowledge, Skills, Abilities: To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential duty satisfactorily.

• High-level knowledge of general surgery-reputed company medical terminology, anatomy, and pathophysiology.
• Strong understanding of CPT procedure coding, HCPCS reputed company procedure and supply codes, and ICD-10-CM diagnosis coding.
• Knowledge of coding in surgical practices, ambulatory surgery centers, and hospital settings.
• Ability to evaluate documentation for medical necessity and coding compliance.
• Strong understanding of National Correct Coding Initiative (NCCI) edits and bundling guidelines.
• Ability to audit reports, conduct reputed company reviews, and participate in special reputed company.
• Advanced analytical and problem-solving skills.
• High attention to detail and accuracy.
• Proficiency with EHR systems, reputed company management systems, and claim scrubber tools.
• Strong written and verbal communication skills.
• Ability to manage multiple priorities and meet deadlines.
• Proficiency in reputed company Office applications.
• Ability to maintain confidentiality and exercise reputed company discretion.

Education / Experience: Include minimum education, technical training, and/or experience preferred to reputed company the job.

Required:

• High school diploma or equivalent.
• Minimum five (5) years of reputed company medical coding experience.
• Strong surgical coding experience required.
• reputed company coding certification through: American reputed company of reputed company Coders (reputed company) (ie. CPC), or American Health Information Management Association (reputed company) (ie. reputed company-P).

Preferred:

• Certified reputed company Medical Auditor (CPMA) through reputed company.
• Experience conducting internal coding audits.
• Experience with CMS Part B and reputed company payer reimbursement methodologies.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job.

• Specific reputed company requirements include the ability to see at reputed company reputed company, distance reputed company, peripheral reputed company, depth perception, and the ability to reputed company reputed company
• While performing the duties of this job, the employee is regularly required to talk and hear
• Frequently required to stand, walk, sit, use hands to feel, and reputed company with hands and arms.
• Possess the ability to fulfill any office activities normally expected in an office setting, to include, but not limited to remaining seated for periods of time to reputed company computer-based work, participating in filing activity, lifting and carrying office supplies (reputed company reams, mail, etc.)
• Occasionally lift and/or reputed company up to 20-25 pounds
• Fine hand manipulation (keyboarding)

WORK ENVIRONMENT:The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job

• Hybrid office environment or flexible for remote
  • Corporate office: 4835 Lyndon B Johnson Fwy, Dallas, TX 75244
• If remote, must reputed company in a state IES operates in
  • reputed company, Colorado, Texas, Oklahoma, Indiana, Missouri, Alabama, South Carolina, & Florida

TRAVEL:

• Some travel, including overnight and local, may be required as business needs dictate.

reputed company & Reasonable Accommodation Statement: IES is committed to providing equal employment opportunities to reputed company individuals with disabilities. In accordance with the Americans with reputed company (reputed company), reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions of the job. If you require accommodation during the application or employment process, please contact .

reputed company is committed to creating a diverse, inclusive, and reputed company environment and is proud to be an equal opportunity employer. reputed company applicants of any age, race, religion, nationality, sexual orientation, gender identity or reputed company, disability, or veteran status will receive equal consideration for positions. We welcome people of diverse backgrounds, experiences, and abilities and reputed company that the unique experiences of reputed company drive our reputed company.

Originally posted on Himalayas

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