Professional Coding Auditor/Consultant

1 month ago


Knoxville, United States PYA, P.C. Full time
Job DescriptionJob Description

PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity Service Line in a quality assurance and project management role.

RESPONSIBILITIES:

  • Responsible for the accurate quality assurance review of PYA coding audits, as well as coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including strength in E/M and surgical coding, especially cardiology and orthopedic surgery. Expertise in facility inpatient and outpatient coding auditing is preferred but not required.
  • The Consultant will assist PYA clients with provider documentation improvement, reviews for billing and other regulatory compliance with third party payers, revenue cycle management, as well as reimbursement methodology advisory support.

REQUIREMENTS:

  • Current credential of CPC/CCS-P or related coding professional credential required
  • Strong understanding of and experience in auditing for compliance with 1995, 1997, and 2021/2023 E/M Guidelines required
  • Experience in surgical coding auditing is required (cardiology and orthopedic surgery is preferred)
  • Additional credentials such as RHIT, CCS, CPMA, or specialty designations desirable
  • Physician financial reimbursement and revenue cycle understanding is preferred
  • Knowledge related to post-acute coding and billing (SNF, Home Health, Palliative Care, Behavioral Health) is a plus
  • Experience presenting to physicians and other healthcare providers required
  • Professional services firm experience desired
  • Ability to work in a fast-paced, high-volume coding audit (5-7 encounters per hour average expected) environment with a team, which expects high-quality deliverables and accuracy to clients
  • Superior communication skills, both oral and written
  • Excellent project management skills
  • Traits that include detail-oriented, flexible, and responsive

ABOUT PYA:

Ranked among the top CPA firms in the nation by USA Today, Forbes, and INSIDE Public Accounting, PYA is also a leader in the percentage of female ownership. We are a Top 15 auditor of the nation’s largest health systems and are consistently ranked as one of the country’s Top 20 healthcare consulting firms by Modern Healthcare.

Serving clients in all 50 states from our headquarters in Knoxville, as well as offices in Atlanta, Charlotte, Kansas City, Nashville, and Tampa, PYA provides expertise in tax, audit and assurance, IT, and management consulting. PYA’s success results from four decades of steadfast adherence to a culture of responsiveness, integrity, and relationships—both with clients and colleagues—"The PYA Way.”

Learn more at pyapc.com.



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