Facility Coding Auditor

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $33 - $38 / hour

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

🔎 Auditor

👻 Ghost score 0%

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Pinnacle Healthcare Consulting

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1998

🏥 Healthcare

📦 Logistics

⚖️ Legal

Healthcare • Logistics • Legal

Pinnacle Healthcare Consulting is a nationally recognized healthcare consulting firm that provides strategic, financial, operational, compliance, and valuation services to healthcare organizations. The firm offers services including compensation and fair market value opinions, business valuation and transaction support, value-based care strategy, coding and compliance, revenue cycle management, real estate consulting, and life sciences transaction advisory. Pinnacle serves hospitals, health systems, physician practices, ambulatory surgery centers, digital health companies, dialysis and kidney care companies, law firms, private equity, and nonprofit organizations, delivering practical, data-driven solutions to manage risk, improve performance, and support transactional and regulatory needs.

📋 Description

• Conduct detailed audits of medical records and coding data from ASC procedures to ensure accuracy and compliance with ICD-10, CPT, and HCPCS coding standards • Identify and document coding errors, inconsistencies, and potential compliance risks, providing clear and constructive feedback to coding staff and clinical teams • Collaborate with billing, compliance, and clinical departments to resolve coding discrepancies and support corrective action plans • Stay current with changes in coding guidelines, payer policies, and healthcare regulations to ensure audit practices reflect the latest standards • Prepare comprehensive audit reports and present findings to management, recommending process improvements to enhance coding accuracy and reimbursement outcomes

🎯 Requirements

• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) credential • Minimum of 5 years of experience in medical coding, preferably within an Ambulatory Surgery Center or similar outpatient setting • Strong knowledge of ICD-10-CM, CPT, and HCPCS coding systems and guidelines • Familiarity with healthcare compliance regulations including HIPAA and the False Claims Act • Proficiency in using electronic health records (EHR) and coding audit software • Preferred: Certified Coding Auditor (CCA) or Certified Inpatient Coder (CIC) certification • Preferred: Experience with ASC billing and reimbursement processes • Preferred: Background in healthcare quality assurance or compliance auditing • Preferred: Advanced knowledge of payer-specific coding and billing requirements • Preferred: Strong analytical skills with experience in data analysis and reporting tools