Senior Auditor, Revenue Optimization; Remote

Position: Senior Auditor, Revenue Optimization (Remote)
Sunrise,FL - USA Position Requirements ACTIVITY / RESPONSIBILITY Team Leadership & Operational Support:
Provide day-to-day functional leadership and technical support to Revenue Optimization Auditors. Serve as a primary Subject Matter Expert (SME) for audit processes, coding and billing questions, departmental policies, and workflow requirements. Provide guidance on complex cases, support workload coordination, reinforce departmental expectations, and escalate significant operational, performance, or compliance concerns to the Manager as appropriate.

Revenue Optimization Auditing:
Perform and support complex revenue optimization audits, including coding, billing, documentation, revenue integrity, and other assigned audit activities. Evaluate records for accuracy, completeness, and adherence to applicable requirements while identifying under-coding, over-coding, missed billing opportunities, documentation deficiencies, and other potential revenue or compliance concerns.

Quality Assurance:
Conduct scheduled quality assurance reviews of auditor work to evaluate accuracy, consistency, documentation, and adherence to established audit methodology, policies, and procedures. Provide timely and constructive feedback, identify trends requiring additional education or process clarification, and communicate significant findings to management.

Reporting & Recommendations:
Develop, review, and present audit results and supporting examples to management and other stakeholders. Summarize key findings, revenue opportunities, coding and documentation trends, compliance considerations, root causes, and recommended corrective or preventive actions.

Data Analysis & Revenue Integrity:
Utilize available reporting and data analytics tools to analyze audit populations and large datasets, identify patterns and anomalies, and evaluate potential revenue integrity concerns, including under-coding, over-coding, missed charges, documentation deficiencies, and other billing opportunities or risks.

Education & Staff Development:
Provide coaching, education, and technical guidance to Auditors, Coders, Physicians, and other stakeholders, as appropriate, regarding audit findings, coding guidelines, documentation requirements, revenue cycle processes, and identified opportunities for improvement.

New Hire Training & Onboarding:
Support the onboarding and development of newly hired Revenue Optimization Auditors by providing workflow training, technical instruction, mentoring, case review, and ongoing feedback to promote successful transition into independent audit responsibilities.

Process Improvement:
Promote continuous improvement by identifying opportunities to strengthen audit methodology, standardize workflows, improve quality and efficiency, enhance reporting, and optimize revenue cycle outcomes. Participate in departmental initiatives and special projects as assigned.

Meetings, Escalations & Operational Coordination:
Coordinate and participate in team, departmental, and management meetings; communicate relevant operational updates; support resolution of escalated issues; and assist the Manager with departmental priorities, coverage needs, and other operational responsibilities as assigned.

REQUIRED QUALIFICATIONS High school diploma or equivalent required.

Current CPC or CCS certification, plus CPMA, CANPC, or an equivalent professional auditing or anesthesia coding certification.

Minimum of 5 years of professional medical coding, auditing, revenue integrity, or revenue cycle experience, including significant experience auditing anesthesia services.

Advanced knowledge of anesthesia coding, billing, documentation, and reimbursement requirements.

Demonstrated ability to interpret and apply CPT, ASA Crosswalk, ICD-10-CM, HCPCS, payer requirements, CMS guidance, and other applicable coding and billing regulations.

Demonstrated experience performing coding, documentation, revenue optimization, or compliance-focused audits.

Strong analytical skills with the ability to evaluate complex information, identify trends and root causes, and translate findings into actionable recommendations.

Demonstrated ability to provide technical guidance, coaching, training, and constructive feedback to peers and team members.

Strong written and verbal communication skills, including the ability to communicate complex audit and coding concepts clearly to technical and non-technical audiences.

Strong organizational and time-management skills with the ability to manage competing priorities,…