Facility Outpatient Surgical & Claims Auditor

Job Summary

The Facility Outpatient Surgical & Claims Auditor will work under the guidance of the Coding Supervisor to conduct detailed reviews of patient encounters in both pre‑bill and retrospective workflows. The auditor validates coding accuracy, identifies missed query opportunities, and ensures compliance with internal policies as well as national standards set by the AHA and AMA. Key responsibilities include performing quality coding audits, assisting with post‑audit billing adjustments, and preparing concise summary reports. The role also involves educating staff through 1:1 or small group sessions, collaborating with departments such as Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI), and contributing to data quality initiatives that support accurate billing and reimbursement. The auditor will maintain open communication with internal partners, perform data trend analyses, and produce actionable recommendations to improve billing accuracy and overall quality of care. The position may also support production coding during staff shortages and contribute content to the coding newsletter.

Key Responsibilities

• The Facility Outpatient Surgical & Claims Auditor will work under the guidance of the Coding Supervisor to conduct detailed reviews of patient encounters in both pre‑bill and retrospective workflows. The auditor validates coding accuracy, identifies missed query opportunities, and ensures compliance with internal policies as well as national standards set by the AHA and AMA. Key responsibilities include performing quality coding audits, assisting with post‑audit billing adjustments, and preparing concise summary reports. The role also involves educating staff through 1:1 or small group sessions, collaborating with departments such as Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI), and contributing to data quality initiatives that support accurate billing and reimbursement. The auditor will maintain open communication with internal partners, perform data trend analyses, and produce actionable recommendations to improve billing accuracy and overall quality of care. The position may also support production coding during staff shortages and contribute content to the coding newsletter.

About the Role

This role is ideal for someone who enjoys combining strategy, content, data and execution. You will work with cross-functional teams and contribute directly to the company’s digital growth in Kolkata and surrounding areas.

Job Requirements

• Medical Coding
• Coding Audit

Required Skills