Senior Coding Auditor – India (Healthcare Coding & Compliance)
Location: India
Job Type: Full-Time
Role: Senior Coding – Auditor
Experience Required: Minimum 6 years in medical coding and 8 years of total professional experience
Education: Graduate in Life Sciences with valid CPC or CCS certification
Job Overview
We are seeking an experienced Senior Coding Auditor to support high-quality clinical coding audits, compliance reviews, and education across multiple medical specialties. This role involves auditing complex services provided by physician and non-physician practitioners, ensuring adherence to current coding guidelines, Medicare requirements, medical necessity standards, and NCD/LCD policies.
The ideal candidate will possess strong expertise in Evaluation and Management (E/M) coding, surgical coding, and a deep focus on orthopedic surgery. Experience in professional inpatient E/M services is essential. This position also includes delivering coding education and consultation to physicians, clinical staff, and revenue cycle teams.
Key Responsibilities
Conduct comprehensive audits of coding and billing practices to ensure regulatory compliance and identify improvement opportunities.
Prepare detailed audit reports, outlining findings, recommendations, and corrective actions for providers and internal teams.
Perform monthly monitoring reviews to validate coding accuracy across diagnoses, procedures, and related documentation.
Review claims to verify appropriate use of ICD-10-CM, CPT, HCPCS, modifiers, and place of service codes.
Stay current with updated coding regulations, industry policies, E/M guideline changes, and compliance standards.
Design, develop, and support coding education programs for clients, coders, and healthcare providers.
Train physicians, coding teams, and clinical staff on documentation improvement, coding accuracy, and regulatory requirements.
Ensure strict management of Protected Health Information in accordance with HIPAA guidelines.
Required Qualifications
Graduate in Life Sciences with coding certifications such as CPC or CCS.
Minimum 6 years of experience in medical coding and 8 years overall professional experience.
At least 3 years of experience in orthopedic surgery coding and E/M coding.
Minimum 2 years in a coding auditor or coding educator role.
Expertise in auditing using 1995, 1997, 2021, and 2023 E/M Guidelines.
Additional credentials such as RHIT, CCS, CPMA, or specialty certifications are desirable.
Strong understanding of physician reimbursement methodologies and revenue cycle processes.
Proven experience presenting and training physicians and clinical teams.
Ability to work efficiently in a high-volume audit environment, averaging 5–7 encounters per hour.
Excellent written and verbal communication skills.
Strong project management capabilities and a detail-oriented, flexible work style.
Experience working with multiple practice management systems.
Advanced proficiency in Microsoft Word and Excel.
Demonstrated commitment to continuous improvement and service excellence.
Why This Role Matters
This role is critical in ensuring high-quality documentation, regulatory compliance, and accurate reimbursement for healthcare organizations. The Senior Coding Auditor acts as a key partner to clinical and revenue cycle teams, driving accuracy, compliance, and operational excellence.
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