Sage Clinical RCM, LLC · 8 hours ago
Outpatient Coding Auditor – Surgical Specialty
United States
Full-time
Remote
Mid, Senior Level
4+ years expSage Clinical RCM, LLC is a company focused on audit services in the healthcare sector, and they are seeking an Outpatient Auditor with a surgical specialty focus. The role involves conducting detailed reviews of outpatient surgical coding to ensure accuracy and compliance, while also identifying documentation deficiencies and revenue opportunities.
Hospital & Health Care
Hiring Manager
Jillian Casey
Responsibilities
Conduct detailed retrospective and concurrent audits of outpatient surgical cases and ancillary encounters
Review operative reports, progress notes, and ancillary documentation to ensure accurate CPT, HCPCS, and ICD-10-CM code assignment
Verify coding accuracy in accordance with CMS, CPT, ICD-10, and facility-specific guidelines
Identify coding errors, compliance risks, and documentation improvement opportunities
Prepare and deliver clear, well-documented audit findings and summaries for clients and internal leadership
Collaborate with the HIM and Education teams to provide feedback and targeted coder education
Maintain current knowledge of regulatory changes, including NCCI edits, OPPS, APC grouping, and CPT Assistant guidance
Participate in internal quality assurance reviews to ensure consistency and compliance with organizational standards
Qualification
Required
Certification required: CPC, COC, or CIC (AAPC or AHIMA equivalent accepted)
Experience: Minimum of 4 years of hospital-based outpatient coding experience and at least 2 years of hospital-based outpatient auditing experience
Strong understanding of CPT and ICD-10-CM guidelines for outpatient surgery, observation, and ancillary services
Familiarity with OPPS/APC reimbursement methodologies
Excellent written and verbal communication skills
Ability to work independently, meet deadlines, and manage multiple audit assignments
Preferred
Experience with ambulatory surgery centers (ASC) and hospital outpatient departments (HOPDs)
Prior exposure to audit reporting tools and EHR systems such as Epic, Cerner, or Meditech
Experience with TruBridge, TruCode, or 3M encoder environments
Knowledge of compliance and payer audit trends
Company
Sage Clinical RCM, LLC
Sage Clinical RCM is a tech-enabled clinical revenue cycle firm transforming how healthcare organizations achieve clarity, accuracy, and performance across the revenue cycle.
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase