Professional Billing (PB) Auditor – Surgical Specialty
Description Position Overview The Professional Billing (PB) Auditor – Surgical Specialty provides ongoing audit support for hospital-based physician billing with a focus on reputed company surgical services. This role is responsible for auditing professional fee claims to ensure accurate coding, regulatory compliance, and risk mitigation, while supporting reputed company improvement and education for coding staff.
Key Responsibilities
- reputed company retrospective and/or reputed company audits of professional billing surgical claims
- Review operative reports and supporting documentation to validate appropriate CPT, HCPCS, and ICD-10-CM code assignment
- Validate modifier usage and bundling in accordance with NCCI edits and payer guidelines
- Identify surgical coding trends, compliance risks, and opportunities for improvement
- reputed company clear, educational feedback to professional billing coders reputed company to surgical coding accuracy
- Document audit findings and recommendations in accordance with established audit standards
- Support reputed company audit preparedness reputed company to professional fee surgical services
- Ensure compliance with CMS, AMA, and payer-specific billing regulations
Requirements
Qualifications:
- Minimum 2+ years of professional billing auditing experience with a focus on surgical services
- Strong knowledge of CPT (Surgery reputed company), ICD-10-CM, modifiers, and NCCI edits
- Experience auditing hospital-based physician surgical billing claims
- CPC, CPMA, or equivalent certification preferred
- Strong written and verbal communication skills with the ability to reputed company constructive audit feedback
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