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Description
Sage Clinical RCM, LLC is seeking an experienced Outpatient Coding Auditor with a strong background in surgical coding. This role is responsible for auditing outpatient surgical encounters to ensure accurate code assignment, compliance with regulatory guidelines, and adherence to payer and client requirements. The ideal candidate has hands-on experience auditing complex outpatient surgical cases and providing clear, constructive feedback to coding staff.
Key Responsibilities
Perform audits of outpatient surgical encounters, including operative reports and related documentation
Validate accurate assignment of CPT, ICD-10-CM, modifiers, and applicable APCs
Ensure compliance with CMS, payer, and official coding guidelines
Identify trends, risks, and educational opportunities based on audit findings
Provide written audit feedback and coding education to support quality improvement
Collaborate with coding leadership and quality teams to address identified issues
Maintain required productivity, accuracy, and turnaround standards
Requirements
Required Qualifications
3+ years
of outpatient coding audit experience with a focus on
surgical specialties
Strong knowledge of CPT (Surgery section), ICD-10-CM, and modifier usage
Experience auditing operative reports and post-operative documentation
Familiarity with CMS guidelines, NCCI edits, and payer-specific rules
Ability to clearly document audit findings and recommendations
High attention to detail and strong analytical skills
Preferred
Experience auditing high-volume surgical specialties such as orthopedics, general surgery, ENT, GI, or OB/GYN
Prior experience supporting internal or external audits, quality initiatives, or education programs
Familiarity with Epic, 3M, Optum, TruCode, or similar coding tools
CPC, CCS, or equivalent credential (active and in good standing)