ED Billing Auditor

Conduct audits of ED billing and coding, review provider documentation, identify patterns of undercoding, upcoding, and medical necessity issues, and prepare detailed audit reports.

Requirements

• 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.