Coding Auditor Consultant

PYA is actively seeking a talented Coding Auditor Consultant to join our esteemed firm known for its dynamic culture and outstanding national reputation. This role is integral to supporting our Revenue Integrity team with quality assurance and project management. Key Responsibilities: Conduct thorough quality assurance reviews of PYA coding audits. Audit complex coding services by physician and non-physician practitioners, adhering to current coding guidelines, especially focusing on Medicare, medical necessity, and NCD/LCD requirements. Provide professional coding auditing expertise across various specialties, with particular emphasis on E/M and surgical coding, notably in cardiology and orthopedic surgery. Support clients in provider documentation improvement, billing reviews, and regulatory compliance with third-party payers. Assist with revenue cycle management and offer reimbursement methodology advisory support. Essential Qualifications: Active credential of CPC/CCS-P or related coding professional credential. Strong understanding and experience in auditing for compliance with the 1995, 1997, and 2021/2023 E/M Guidelines. Experience in surgical coding auditing, especially in cardiology and orthopedic surgery. Additional credentials (RHIT, CCS, CPMA, or specialty designations) are desirable. Knowledge of physician financial reimbursement and revenue cycle principles is a plus. Understanding of post-acute coding and billing (SNF, Home Health, Palliative Care, Behavioral Health) is beneficial. Experience presenting to healthcare providers is required. Ability to thrive in a fast-paced, high-volume coding audit environment, with an expectation to process 5-7 encounters per hour. Exceptional communication skills, both oral and written, along with excellent project management abilities. Detail-oriented, flexible, and responsive traits are essential. About PYA: PYA is a leading professional services firm providing expert healthcare consulting, accounting, compliance, and business strategy across the United States. We are dedicated to helping clients achieve their goals through innovative solutions and unmatched service. Why Join PYA? Be part of a collaborative team that embraces innovation and excellence. Work alongside industry leaders committed to your professional growth and client success. Enjoy competitive compensation, comprehensive benefits, and opportunities for career advancement.