Want to know if this job is worth applying to?
Jaroměř, Česko
Remote only
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Surgery Coding Auditor based in the United States.
This fully remote role focuses on auditing surgical and procedural coding across multiple healthcare facilities.
You will evaluate coding accuracy, documentation support, compliance, bundling, modifiers, and reimbursement implications.
The position requires strong expertise in surgical coding and the ability to identify errors, risks, and opportunities for process improvement.
You will document findings with authoritative support and contribute to detailed audit reports and corrective-action recommendations.
The role also includes facility-specific coding education and participation in stakeholder discussions and exit conferences.
You will work independently while collaborating with health information management leadership and facility personnel.
The assignment combines technical coding expertise, analytical review, education, and quality assurance within a highly regulated healthcare environment.
Independently audit surgical and procedural coding for accuracy, documentation support, compliance, and reimbursement impact.
Evaluate ICD-10-CM, CPT, HCPCS Level II, modifier, global-package, and Correct Coding Initiative bundling assignments.
Review surgical diagnoses and procedures in electronic health records and approved audit tools according to established sampling requirements.
Identify incorrect, missing, unbundled, upcoded, downcoded, unsupported, or otherwise noncompliant codes and modifiers.
Assess whether clinical documentation adequately supports reported surgical and procedural services.
Document each audit finding with authoritative coding guidance, financial impact, risk assessment, and recommended corrective action.
Maintain a minimum audit accuracy of 95% and participate in calibration activities to support consistency among reviewers.
Contribute to audit work plans, collection tools, facility-level reports, consolidated reports, and progress updates.
Review preliminary findings with health information management leadership, the Contracting Officer's Representative, management, and designated facility personnel.
Prepare or support final reports addressing coding accuracy, documentation issues, financial impact, process improvement, and educational opportunities.
Develop and deliver facility-specific coding education using audit findings and a train-the-trainer approach when assigned.
Support exit conferences and clearly explain coding findings, recommendations, and applicable authoritative guidance.
Protect sensitive healthcare information and comply with privacy, information-security, encryption, and remote-work requirements.
Complete assigned audits, reporting, training, credentialing, and access activities within established schedules and requirements.
Active RHIA, RHIT, CCS, CCS-P, CPC, or CPC-H credential from an accepted professional organization.
At least two years of coding experience in the applicable coding specialty.
At least three years of consultant experience reviewing records in large tertiary-care hospitals and outpatient organizations with primary care and subspecialty services.
At least three years of education and training experience, including the ability to present audit findings and deliver facility-specific coding education.
Strong knowledge of surgical and procedural coding, including ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, modifiers, global surgical packages, bundling rules, reimbursement, documentation, and compliance requirements.
Demonstrated ability to assess documentation sufficiency and determine whether surgical and procedural codes are appropriately supported.
Strong analytical and critical-thinking skills with the ability to identify coding discrepancies and clearly explain their compliance, financial, and operational implications.
Ability to maintain at least 95% audit accuracy while meeting reporting and turnaround requirements.
Excellent written, verbal, presentation, and interpersonal communication skills.
Strong attention to detail, organization, documentation, and quality control.
Ability to work independently while collaborating effectively with health information management leadership and facility stakeholders.
U.S. citizenship and English-language proficiency required for system access.
Ability to successfully complete a Low Risk NACI background investigation and all required privacy, information-security, and mandatory training.
Ability to work securely from an approved location within the United States and protect sensitive healthcare information.
Candidates must provide a current resume, signed Letter of Intent, completed candidate cover page, proof of an active accepted credential, and two current client references specific to the individual reviewer.
Compensation: Estimated total compensation of $38.00 per hour.
Work arrangement: Fully remote within the United States.
Employment options: Full-time or part-time, depending on assigned workload.
Contract period: Expected performance period from January 1, 2027 through December 31, 2031, if all option periods are exercised.
Professional impact: Opportunity to improve surgical coding accuracy, documentation quality, compliance, reimbursement integrity, and education across multiple healthcare facilities.
Specialized experience: Exposure to surgical and procedural coding audits, compliance analysis, financial-impact assessment, reporting, and facility-level education.
Structured environment: Work within established audit methodologies, coding standards, quality requirements, privacy controls, and healthcare information management processes.
Remote flexibility: Perform work from a secure, approved location in the United States using authorized systems, coding tools, and reference resources.
