Senior Coding Auditor – India
Location: India
Job Type: Full-Time
Position Overview
We are seeking an experienced Senior Coding Auditor with advanced expertise in surgical and orthopedic coding. This role is responsible for auditing complex medical services, ensuring coding accuracy, compliance with national guidelines, and supporting clinical and revenue cycle teams through structured training and education.
The ideal candidate will possess deep knowledge of Evaluation and Management (E/M) coding, surgical coding, Medicare requirements, and NCD/LCD guidelines. This is a senior-level position requiring strong communication, analytical skills, and the ability to work in a demanding, high-volume audit environment.
Key Responsibilities
Conduct comprehensive audits of coding and billing practices to ensure full compliance with regulatory standards and payer requirements.
Prepare detailed audit reports outlining findings, improvement areas, and recommendations for clinical and administrative teams.
Review medical records monthly to assess the accuracy of diagnosis and procedure codes including ICD-10-CM, CPT, HCPCS, modifiers, and place-of-service assignments.
Validate claims data and ensure accurate code abstraction for physician and non-physician services.
Stay updated with evolving coding regulations, including E/M guidelines (1995, 1997, 2021/2023).
Design, develop, and implement coding education programs for providers, coders, and internal teams.
Deliver training on documentation standards, compliance requirements, and best practices in medical coding and Clinical Documentation Improvement (CDI).
Manage Protected Health Information (PHI) in compliance with HIPAA standards.
Experience Required
Minimum 8 years of overall experience, including at least 6 years in medical coding, auditing, or related specialties.
Minimum 3 years of orthopedic surgery and E/M coding experience; experience in other surgical specialties is also considered.
Minimum 2 years in a professional coding auditor or coding educator role.
Experience working in a fast-paced, high-volume audit environment (5–7 encounters per hour).
Proven experience presenting training to physicians, coders, and healthcare teams.
Experience working with multiple practice management and documentation systems.
Qualifications
Graduate degree in Life Sciences or related discipline.
Mandatory coding certifications: CPC or CCS (AAPC or AHIMA).
Additional credentials such as RHIT, CPMA, CCS, or specialty certifications are preferred.
Strong understanding of E/M coding guidelines (1995, 1997, 2021/2023).
Expertise in surgical and orthopedic coding, professional inpatient E/M services, and compliance requirements.
Strong knowledge of Microsoft Office, particularly Word and Excel.
Excellent verbal and written communication skills.
Strong project management abilities and attention to detail.
Ability to work independently as well as collaboratively within a team environment.
Core Competencies
High level of accuracy and analytical skill.
Strong stakeholder management capability.
Detail-oriented, adaptable, and responsive.
Commitment to continuous operational improvement.
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