Outpatient Coding Auditor – Surgical Specialty

🔥 22 minutes ago

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Sage Clinical RCM, LLC

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2024

🏥 Healthcare

☁️ SaaS

🤝 B2B

Healthcare • SaaS • B2B

Sage Clinical RCM is a healthcare revenue cycle management company that combines proprietary technology with clinical and financial expertise to provide end-to-end RCM solutions—from patient access through financial close. The firm offers advisory services, revenue cycle management operations, technology adoption (including clinical documentation improvement and autonomous coding), workforce augmentation (coding, documentation, RCM, physician advisory), and analytics-driven platforms (Sage IQ: Validity and VERO) that use automation and AI to unify coding, documentation, vendor performance, compliance, and financial reporting for healthcare organizations.

📋 Description

• Perform audits of outpatient surgical encounters, including operative reports and related documentation • Validate accurate assignment of CPT, ICD-10-CM, modifiers, and applicable APCs • Ensure compliance with CMS, payer, and official coding guidelines • Identify trends, risks, and educational opportunities based on audit findings • Provide written audit feedback and coding education to support quality improvement • Collaborate with coding leadership and quality teams to address identified issues • Maintain required productivity, accuracy, and turnaround standards

🎯 Requirements

• 3+ years of outpatient coding audit experience with a focus on surgical specialties • Strong knowledge of CPT (Surgery section), ICD-10-CM, and modifier usage • Experience auditing operative reports and post-operative documentation • Familiarity with CMS guidelines, NCCI edits, and payer-specific rules • Ability to clearly document audit findings and recommendations • High attention to detail and strong analytical skills