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ED Billing Auditor at Exceptional Healthcare Inc.
, , -
Full Time

Start Date

Immediate

Expiry Date

13 Apr, 26

Salary

0.0

Posted On

13 Jan, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

ED Billing, Coding, CPT, ICD-10, HCPCS, Compliance, Documentation Review, Analytical Skills, Communication Skills, Education, Training, Audit Reports, Regulatory Changes, Billing Workflows, Internal Policies, EMR Systems, Feedback

Industry

Hospitals and Health Care

Description
We Conduct audits of ED billing and coding for accuracy, completeness, and compliance with CPT, ICD-10, HCPCS, and payer-specific guidelines. Review provider documentation to ensure it supports billed services and appropriate E/M levels. Identify patterns of undercoding, upcoding, bundling errors, or medical necessity issues. Collaborate with coders, billers, and providers to correct errors and provide education/training as needed. Prepare detailed audit reports with findings, trends, and actionable recommendations. Stay up-to-date with regulatory changes from CMS, commercial payers, and industry best practices specific to emergency medicine. Work cross-functionally with compliance, revenue integrity, and quality assurance teams to improve billing workflows and reduce audit risks. Participate in internal and external audits (e.g., RAC, MAC, private payer audits). Help develop internal policies and audit plans related to ED coding and billing practices. Review clinical documentation and provide feedback. Qualifications: 3+ years of experience in medical billing or coding, with a focus on Emergency Department services. Certification required: CPC, CPMA, or CCS-P (AHIMA or AAPC). In-depth knowledge of E/M guidelines, NCCI edits, CMS billing rules, and payer-specific policies. Strong familiarity with coding for ED services, including trauma activations, procedures, and critical care. Experience using EMR and billing systems such as CMD, Change Healthcare, EPD, or GoRev. Excellent analytical and documentation skills. Strong communication skills with the ability to provide constructive feedback to providers and team members.
Responsibilities
Conduct audits of ED billing and coding for accuracy and compliance, and collaborate with coders and providers to correct errors. Prepare detailed audit reports and stay updated with regulatory changes to improve billing workflows.