Home and Stone Investments
Professional Billing (PB) Auditor – Surgical Specialty
Home and Stone Investments, St. Petersburg, Florida, United States, 33739
Professional Billing (PB) Auditor – Surgical Specialty
Join to apply for the
Professional Billing (PB) Auditor – Surgical Specialty
role at
Home and Stone Investments
Employment Type:
Full-Time
Hours:
30-40 hours per week
Experience Required:
2+ years PB auditing (surgical focus)
Position Overview The
Professional Billing (PB) Auditor – Surgical Specialty
provides ongoing audit support for hospital-based physician billing with a focus on
complex surgical services . This role is responsible for auditing professional fee claims to ensure accurate coding, regulatory compliance, and risk mitigation, while supporting continuous improvement and education for coding staff.
Key Responsibilities
Perform retrospective and/or concurrent audits of professional billing surgical claims
Review operative reports and supporting documentation to validate appropriate CPT, HCPCS, and ICD-10-CM code assignment
Validate modifier usage and bundling in accordance with NCCI edits and payer guidelines
Identify surgical coding trends, compliance risks, and opportunities for improvement
Provide clear, educational feedback to professional billing coders related to surgical coding accuracy
Document audit findings and recommendations in accordance with established audit standards
Support internal and external audit preparedness related to professional fee surgical services
Ensure compliance with CMS, AMA, and payer-specific billing regulations
Required Qualifications
Minimum 2+ years of professional billing auditing experience with a focus on surgical services
Strong knowledge of CPT (Surgery section), ICD-10-CM, modifiers, and NCCI edits
Experience auditing hospital-based physician surgical billing claims
CPC, CPMA, or equivalent certification preferred
Strong written and verbal communication skills with the ability to provide constructive audit feedback
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Professional Billing (PB) Auditor – Surgical Specialty
role at
Home and Stone Investments
Employment Type:
Full-Time
Hours:
30-40 hours per week
Experience Required:
2+ years PB auditing (surgical focus)
Position Overview The
Professional Billing (PB) Auditor – Surgical Specialty
provides ongoing audit support for hospital-based physician billing with a focus on
complex surgical services . This role is responsible for auditing professional fee claims to ensure accurate coding, regulatory compliance, and risk mitigation, while supporting continuous improvement and education for coding staff.
Key Responsibilities
Perform retrospective and/or concurrent audits of professional billing surgical claims
Review operative reports and supporting documentation to validate appropriate CPT, HCPCS, and ICD-10-CM code assignment
Validate modifier usage and bundling in accordance with NCCI edits and payer guidelines
Identify surgical coding trends, compliance risks, and opportunities for improvement
Provide clear, educational feedback to professional billing coders related to surgical coding accuracy
Document audit findings and recommendations in accordance with established audit standards
Support internal and external audit preparedness related to professional fee surgical services
Ensure compliance with CMS, AMA, and payer-specific billing regulations
Required Qualifications
Minimum 2+ years of professional billing auditing experience with a focus on surgical services
Strong knowledge of CPT (Surgery section), ICD-10-CM, modifiers, and NCCI edits
Experience auditing hospital-based physician surgical billing claims
CPC, CPMA, or equivalent certification preferred
Strong written and verbal communication skills with the ability to provide constructive audit feedback
#J-18808-Ljbffr