Senior Coding Auditor | India
Location: India
Category: Medical Coding / Revenue Cycle
Job Type: Full-Time
Job Overview
We are seeking an experienced Senior Coding Auditor with a strong focus on orthopedic surgical coding and Evaluation & Management (E/M) services. The ideal candidate will have extensive expertise in auditing complex physician and non-physician services, ensuring compliance with current coding standards, Medicare guidelines, and National Coverage Determinations (NCD/LCD). This role also involves educating physicians, clinical teams, and revenue cycle staff to optimize coding accuracy and compliance.
This is an excellent opportunity for professionals with a minimum of 6 years in coding audits and 8 years overall experience to contribute to operational excellence in a dynamic healthcare environment.
Key Responsibilities
Conduct audits of coding and billing practices for physicians and clinical teams, ensuring compliance with ICD-10, CPT, HCPCS, modifiers, and place-of-service codes.
Review and validate submitted claims, focusing on complex surgical and E/M coding, especially in orthopedic procedures.
Prepare detailed audit reports with recommendations to improve coding accuracy and compliance.
Provide education and training programs for coding staff, physicians, and other healthcare providers on coding best practices and documentation requirements.
Maintain up-to-date knowledge of coding regulations, policies, and compliance standards.
Perform monitoring reviews of medical records to assess coding accuracy and implement process improvements.
Handle Protected Health Information (PHI) in compliance with HIPAA regulations.
Collaborate with revenue cycle teams to drive actionable insights and ensure alignment with organizational goals.
Qualifications & Experience
Bachelor’s degree in Life Sciences or related field; advanced coding certifications required: CPC, CCS.
Minimum 6 years of professional coding auditing experience and 8 years overall experience in medical coding.
At least 3 years of orthopedic surgery and E/M coding experience; experience in other surgical specialties considered.
Proven experience in auditing for compliance with 1995, 1997, and 2021/2023 E/M Guidelines.
Additional credentials such as RHIT, CPMA, or specialty designations are desirable.
Strong understanding of physician reimbursement and revenue cycle operations.
Demonstrated ability to present findings to physicians and clinical teams.
Familiarity with multiple practice management systems and advanced proficiency in Microsoft Office (Word, Excel).
Excellent project management, analytical, and problem-solving skills.
Detail-oriented, flexible, and capable of working in a high-volume, fast-paced environment (5–7 encounters per hour average).
Key Skills
Exceptional verbal and written communication for cross-functional stakeholder engagement.
Strong attention to detail and accuracy in audit reporting.
Ability to design and deliver training programs for coding staff and healthcare providers.
Knowledge of regulatory requirements, compliance, and coding standards.
Collaborative mindset with a commitment to continuous operational improvement.
Why Join Us?
Work with a leading healthcare organization driving compliance, accuracy, and operational excellence in medical coding.
Opportunity to mentor and educate teams, influencing clinical and revenue cycle processes.
Engage in a high-growth, professional environment with access to the latest coding tools and systems.
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