Surgical Billing Auditor

Job Summary

A company is looking for a Professional Billing (PB) Auditor - Surgical Specialty.

Key Responsibilities

• Perform retrospective and/or concurrent audits of professional billing surgical claims
• Review operative reports and supporting documentation to validate appropriate coding
• Identify surgical coding trends, compliance risks, and opportunities for improvement

Required Qualifications

• Minimum 2+ years of professional billing auditing experience with a focus on surgical services
• Strong knowledge of CPT (Surgery section), ICD-10-CM, modifiers, and NCCI edits
• Experience auditing hospital-based physician surgical billing claims
• CPC, CPMA, or equivalent certification preferred