Sr Professional Facility Auditor

extra holidays - extra parental leave
Work set-up: 
Full Remote
Contract: 
Full time
Experience: 
Senior (5-10 years)
Work from: 
Florida (USA)

Offer summary

Qualifications:

Certified Professional Coder (CPC), CCS-P, COC, RHIT, or RHIA with coding and auditing experience., Extensive knowledge of medical terminology, anatomy, physiology, and billing regulations., Experience auditing facility and professional medical coding, including complex encounters., Preferred: Associate’s degree or higher, coursework in anatomy and physiology..

Key responsibilities:

  • Conduct comprehensive audits of facility and professional coding, including ICD-10, CPT4, HCPCS, and UB04 codes.
  • Lead educational sessions for coders based on audit findings to ensure compliance.
  • Stay updated with CMS, Medicare, and other regulatory updates to maintain coding standards.
  • Collaborate with healthcare providers to identify and improve documentation and coding practices.

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Nuvance Health XLarge http://www.nuvancehealth.org/
10001 Employees
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Job description

Description
Position at Nuvance Health

Must reside in the following states: 
AZ, CT, DE, FL, GA, IL, IN, KS, MA, MD, ME, MI, MS, NC, NH, NJ, NY, OH, PA, SC, TN, TX, and VA.

Job Title: Senior Professional Facility Auditor
Company: Nuvance Health
Department: Facility Charging and Coding
Location: Remote
Employment Type: Full-Time | Non-Exempt
Salary Range: $28 – $53/hour
About the Role
Nuvance Health is seeking a detail-oriented and experienced Senior Professional Facility Auditor to join our Facility Charging and Coding team. In this role, you will perform in-depth audits of facility and professional coding to ensure clinical documentation supports services rendered. Your expertise in medical terminology, anatomy, physiology, regulatory compliance, and coding guidelines will be essential in driving accuracy and improving documentation and billing practices across our organization.
Key Responsibilities
  • Conduct comprehensive audits of ICD-10, CPT4, HCPCS, E/M codes, medical supplies, orders, and UB04/revenue codes for both facility and professional services.
  • Lead educational sessions for coders based on audit findings to reinforce compliance with CMS, Medicare, state/federal regulations, and internal policies.
  • Stay current with CMS, NGS Medicare, AAPC, and OIG updates, bulletins, and compliance requirements to ensure up-to-date coding standards.
  • Collaborate with physician and hospital coding leadership to identify documentation and coding trends, errors, and improvement opportunities.
  • Perform accurate coding and charging for complex clinical services, including interventional cardiology, radiology, and vascular procedures.
  • Utilize internal systems and applications with a high level of competency to ensure audit accuracy and reporting efficiency.
  • Participate in team meetings, ongoing education, and continuous improvement initiatives to support departmental goals.
  • Maintain high standards for customer service, teamwork, safety, and compliance.
  • Perform additional duties as assigned.
Qualifications
Required:
  • CPC, CCS-P, COC, RHIT – With Coding/Auditing experience, RHIA – With Coding/Auditing experience
  • Outpatient Facility Coding  -  Auditing will include facility coding for Interventional Radiology, Cardiac Cath, Outpatient Surgery, Observation, & Ancillary
  • Advanced knowledge of medical terminology, anatomy, physiology, and federal/state documentation and billing regulations
  • Extensive experience auditing both facility and professional medical coding
  • Proficiency in coding complex encounters and using relevant coding systems and software
Preferred (Not Required):
  • Associate’s degree or higher
  • CIRCC & CCC
  • Coursework in Anatomy and Physiology
Work Conditions
  • Physical Effort: Light – primarily sedentary; may exert up to 10 lbs. of force
  • Working Environment: Generally pleasant; no significant occupational risks
  • Communication: Daily interaction including verbal, written, and participation in team meetings
Why Join Nuvance Health?
At Nuvance Health, we are committed to providing outstanding care and support to our patients and teams. Join a collaborative and progressive environment where your skills in compliance, coding, and education can make a measurable impact.

Required profile

Experience

Level of experience: Senior (5-10 years)
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Hard Skills

CorticonICD 503AnatomyMedical AbbreviationsRegulatory CompliancePhysiologyMedical EquipmentCppunitOutpatient CodingCCURE (Security And Event Management System)Anatomy

Other Skills

  • Customer Service
  • Teamwork
  • Detail Oriented
  • Communication
Are you interested?

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