ED Billing Auditor

We Conduct audits of  ED billing and coding  for accuracy, completeness, and compliance with CPT, ICD-10, HCPCS, and payer-specific guidelines.

Review provider documentation to ensure it supports billed services and appropriate E / M levels.

Identify patterns of undercoding, upcoding, bundling errors, or medical necessity issues.

Collaborate with coders, billers, and providers to correct errors and provide education / training as needed.

Prepare detailed audit reports with findings, trends, and actionable recommendations.

Stay up-to-date with regulatory changes from CMS, commercial payers, and industry best practices specific to emergency medicine.

Work cross-functionally with compliance, revenue integrity, and quality assurance teams to improve billing workflows and reduce audit risks.

Participate in internal and external audits (e.g., RAC, MAC, private payer audits).

Help develop internal policies and audit plans related to ED coding and billing practices.

Review clinical documentation and provide feedback.

Qualifications :

• 3+ years of experience in medical billing or coding, with a focus on  Emergency Department services .

Certification required :