Group Auditor - OP Coding

Overview

Group Auditor - OP Coding is responsible for carrying out internal audits focused on revenue cycle transactions including claims, billing, collections, and coding. This role identifies trends and errors, assesses process compliance, and ensures accurate documentation and billing practices. The position collaborates closely with internal teams to address audit findings and implement corrective actions. The position also supports external audit preparation, maintains audit documentation, and contributes to continuous improvement in RCM processes.

Responsibilities

• Execute regular audits on claims, billing records, payment posting, and coding accuracy across various specialties and service lines
• Identify areas of revenue leakage, recurring denial trends, and documentation gaps that affect reimbursement
• Verify that billed services are correctly supported by documentation and aligned with payer-specific rules and guidelines...